[Clinical management of epistaxis].

BACKGROUND: Epistaxis is a symptom with many causes, often multifactorial and a frequent cause of consultation in acute medicine.

OBJECTIVES: The goal of this study is to analyse the diagnostics used for and therapy of epistaxis, complications and the predictive benefit of laboratory tests.

MATERIALS AND METHODS: In this retrospective clinical analysis reports of 720 patients with epistaxis in the period from January 2005 to December 2015 were evaluated. The causes and the therapy of the epistaxis relapses were analysed.

RESULTS: Male patients were predominant. Patients with relapses of epistaxis were significantly more likely to be older than 70 years, with higher multimorbidity and more often had used a combination of blood thinning medications. Posterior bleeding was the most found location and was associated with a longer hospitalization. In laboratory tests most patients with coumarins were shown to have inadequate INR (international normalized ratio) control. The prevalence of nicotine consumption was clearly increased compared to the total population. The most used therapy was nasal tamponade. The most complication was anemia with need of blood transfusion.

CONCLUSIONS: High age and posterior bleeding source seem to raise the necessity of inpatient therapy. In most cases tamponade is sufficient for treatment. Initial laboratory tests are of limited use to estimate risk of recurrence, but is necessary for patients taking coumarins to determine INR control.