Eldely patients with epistaxis. Predisposing factors, seasonal distribution and treatment

Hippokratia 2001, 5(3):99-103

S Triaridis, A Triaridis, J Xanthopoulos, P Papadopoulos, K Karagiannidis, Ch Preponis


Epistaxis is a common ENT problem with multifactorial etiology, It occurs in a1l age groups, most commonly in children (anterior, venous, shorr lived) and in elderly patients (posterior, arterial, prolonged). The incidence and severity of epistaxis increases v/ith advancing age. Furthermore, other health problems of the elderly patient or even social reasons are frequent causes of admission for overnight observation.
In this retrospective study 835 patients who presented in the ENT deparrment of our hospital with acute and chronic epistaxis, between December 1998 and December 2000 were included. The causes, the site and the nature of epistaxis, patients’ age, seasonal distribution and predisposing factors were analyzed. Out of the 27053 patients who were examined in the ENT outpatient clinic, 835 (3.0 %) presented with epistaxis; 347 (41.5 %) of them were elderly patients. Most of the patients were treated successfu1ly with cautery and/or anterior nasal packing. Out of the 41 patients who required hospitalization, 18(44.0 %) were elderly patients (16 with anterior and posterior nasal packing and 2 wirh anterior only packing due to their poor general health condition).
A cause of epistaxis was found in about 25 % of patients: 79 patients (9.5 %) were hyperrensive, 37 (4.4 %) presented after trauma and 32 (3.8 %) were taking some kind of anticoagulation medication.
A higher incidence of noseb1eeding during winter months was found in elderly patients, whereas the seasonal distribution of epistaxis in younger patients has two peaks: during cold winter months and dry, hot summer months.