BACKGROUND: Persistent nosebleed episodes have occurred in patients with idiopathic epistaxis from Kiesselbach's area despite confirmed location of the bleeding site, but the cause remains unclear. We tried to determine whether persistent epistaxis was associated with blood pressure. METHODS AND RESULTS: Between May 2009 and May 2010, the records for 133 adult patients with idiopathic epistaxis from Kiesselbach's area were obtained from the emergency department of our hospital. The bleeding site was pressed with a cotton strip for about 30 minutes, followed by checking for nosebleed. Comparison of background factors by the presence or absence of persistent epistaxis revealed a significantly higher systolic blood pressure in patients with persistent nosebleed than in those without (181.3 ± 26.9 vs. 156.6 ± 26.1 mm Hg; P < .0001). Persistent epistaxis was significantly more frequent in patients with hypertension than in those without (26% vs. 8%; P = .002). Multivariate logistic analysis revealed systolic blood pressure to be an independent factor associated with epistaxis persistence (odds ratio, 1.03; 95% confidence interval, 1.01-1.06; P = .002). CONCLUSION: Proper blood pressure management is necessary for the prevention of persistent epistaxis from Kiesselbach's area in the clinical setting of emergency care practice.
BACKGROUND: Persistent nosebleed episodes have occurred in patients with idiopathic epistaxis from Kiesselbach's area despite confirmed location of the bleeding site, but the cause remains unclear. We tried to determine whether persistent epistaxis was associated with blood pressure. METHODS AND RESULTS: Between May 2009 and May 2010, the records for 133 adult patients with idiopathic epistaxis from Kiesselbach's area were obtained from the emergency department of our hospital. The bleeding site was pressed with a cotton strip for about 30 minutes, followed by checking for nosebleed. Comparison of background factors by the presence or absence of persistent epistaxis revealed a significantly higher systolic blood pressure in patients with persistent nosebleed than in those without (181.3 ± 26.9 vs. 156.6 ± 26.1 mm Hg; P < .0001). Persistent epistaxis was significantly more frequent in patients with hypertension than in those without (26% vs. 8%; P = .002). Multivariate logistic analysis revealed systolic blood pressure to be an independent factor associated with epistaxis persistence (odds ratio, 1.03; 95% confidence interval, 1.01-1.06; P = .002). CONCLUSION: Proper blood pressure management is necessary for the prevention of persistent epistaxis from Kiesselbach's area in the clinical setting of emergency care practice.
Authors: Gelareh Z Gabayan; Michael K Gould; Robert E Weiss; Stephen F Derose; Vicki Y Chiu; Catherine A Sarkisian Journal: Acad Emerg Med Date: 2017-07 Impact factor: 3.451