Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in Northwestern Tanzania: a prospective review of 104 cases

BMC Ear, Nose and Throat Disorders

Phillipo L Chalya¹  Japhet M Gilyoma¹ 

[1] Department of Surgery, Weill- Bugando University College of Health Sciences, Mwanza, Tanzania

关键词: Tanzania;    treatment outcome;    etiology;    Epistaxis;   

Others  :  862842
DOI  :  10.1186/1472-6815-11-8

 received in 2011-02-17, accepted in 2011-09-05,  发布年份 2011

【 摘 要 】

Background

Epistaxis is the commonest otolaryngological emergency affecting up to 60% of the population in their lifetime, with 6% requiring medical attention. There is paucity of published data regarding the management of epistaxis in Tanzania, especially the study area. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Bugando Medical Centre, a tertiary care hospital in Northwestern Tanzania.

Methods

This was a prospective descriptive study of the cases of epistaxis managed at Bugando Medical Centre from January 2008 to December 2010. Data collected were analyzed using SPSS computer software version 15.

Results

A total of 104 patients with epistaxis were studied. Males were affected twice more than the females (2.7:1). Their mean age was 32.24 ± 12.54 years (range 4 to 82 years). The modal age group was 31-40 years. The commonest cause of epistaxis was trauma (30.8%) followed by idiopathic (26.9%) and hypertension (17.3%). Anterior nasal bleeding was noted in majority of the patients (88.7%). Non surgical measures such as observation alone (40.4%) and anterior nasal packing (38.5%) were the main intervention methods in 98.1% of cases. Surgical measures mainly intranasal tumor resection was carried out in 1.9% of cases. Arterial ligation and endovascular embolization were not performed. Complication rate was 3.8%. The overall mean of hospital stay was 7.2 ± 1.6 days (range 1 to 24 days). Five patients died giving a mortality rate of 4.8%.

Conclusion

Trauma resulting from road traffic crush (RTC) remains the most common etiological factor for epistaxis in our setting. Most cases were successfully managed with conservative (non-surgical) treatment alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort. Reducing the incidence of trauma from RTC will reduce the incidence of emergency epistaxis in our centre.

【 授权许可】

   
2011 Gilyoma and Chalya; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Akinpelu OV, Amusa YB, Eziyi JA, Nwawolo CC: A retrospective analysis of aetiology and management of epistaxis in a south-western Nigerian teaching hospital. West Afr J Med 2009, 28:165-8.
• [2]Pond F, Sizeland A: Epistaxis. Strategies for management. Aust Fam Physician 2000, 29:933-8.
• [3]Yueng-Hsiang C, Jih-Chin L: Unilateral Epistaxis. New England Journal of Medicine 2009, 361(9):14.
• [4]Ciaran SH, Owain H: Update on management of epistaxis. The West London Medical Journal 2009, 1:33-41.
• [5]Walker TWM, Macfarlane TV, McGarry GW: The epidemiology and chronobiology of epistaxis: an investigation of Scottish hospital admissions 1995-2004. Clin Otolaryngol 2007, 32:361-5.
• [6]Pope LER, Hobbs CGL: Epistaxis: an update on current management. Postgrad Med J 2005, 81:309-314.
• [7]Nash CM, Field SMB: Epidemiology of Epistaxis in a Canadian Emergency Department. Israeli Journal of Emergency Medicine 2008, 8:24-28.
• [8]Pallin DJ, Chng Y, McKay MP, Emond JA, Pelletier AJ, Camargo CA: Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med 2005, 46:77-81.
• [9]Bernius M, Perlin D: Pediatric ear, nose, and throat emergencies. Pediatr Clin North Am 2006, 53:195.
• [10]Eziyi JAE, Akinpelu OV, Amusa YB, Eziyi AK: Epistaxis in Nigerians: A 3-year Experience. East Cent Afr J Surg 2009, 14(2):93-98.
• [11]Varshney S, Saxena RK: Epistaxis: a retrospective clinical study. Indian Journal of Otolaryngology, Head Neck Surgery 2005, 57:125-129.
• [12]Mgbor NC: Epistaxis in Enugu: A 9 year Review. Nig J of otolaryngology 2004, 1(2):11-14.
• [13]Huang C, Shu C: Epistaxis: A review of hospitalized patients. Chinese medical journal 2002, 65(2):74-78.
• [14]Kaygusuz I, Karlidag T, Keles E, Yalcin S, Alpay HC, Sakallioglu O: Retrospective Analysis of 68 Hospitalized Patients with Epistaxis. Firat Tip Dergisi 2004, 9(3):82-85.
• [15]Chaiyasate S, Roongrotwattanasiri K, Fooanan S, Sumitsawan Y: Epistaxis in Chiang Mai University. J Med Assoc Thai 2005, 88:1282-1286.
• [16]Ijaduola GTA, Okeowo PA: Pattern of epistaxis in the tropics. Cent Afr J Med 1983, 29:77-80.
• [17]Iseh KR, Muhammad Z: Pattern of epistaxis in Sokoto, Nigeria: A review of 72 cases. Ann Afr Med 2008, 7:107-11.
• [18]Daudia A, Jaiswal V, Jones NS: Guidelines for the management of idiopathic epistaxis in adults: how we do it. Clinical Otolaryngology 2008, 33:607-628.
• [19]Rodney JS: Epistaxis: A clinical experience. New England Journal of Medicine 2009, 360:784-9.
• [20]Urvashi R, Raizada RM, Chaturvedi VN: Efficacy of conservative treatment modalities used in epistaxis. Indian Journal of Otolaryngology and Head and Neck Surgery 2004, 56(1):21-23.
• [21]Wurman LH, Sack GJ, Flannery JV, Lipsman RA: The management of epistaxis. American Journal of Otolaryngology 1992, 13(4):193-209.
• [22]Nemer AK, Motassim AR: Evaluation of conservative measures in the treatment of epistaxis. Khartoum Medical Journal 2008, 1(1):15-17.
• [23]Awan MS, Ali MM, Hussain T, Mian MY: Management of pediatrics Epistaxis; A prospective study of 100 cases. Professional Med J 2001, 8(2):226-65.
• [24]Feusi B, Holzmann D, Steurer J: Posterior epistaxis: systematic review on the effectiveness of surgical therapies. Rhinology 2005, 43(4):300-4.
• [25]Umapathy N, Quadri A, Skinner DW: Persistent epistaxis: what is the best practice? Rhinology 2005, 43(4):305-8.
• [26]Andersen PJ, Kjeldsen AD, Nepper-Rasmussen J: Selective embolization in the treatment of intractable epistaxis. Acta Otolaryngol 2005, 125(3):293-7.
• [27]Biswas D, Wilson H, Mal R: Use of systemic prophylactic antibiotics with anterior nasal packing in England, UK. Clin Otolaryngol 2006, 31:566-567.
• [28]Abhay-Gupta , Agrawal SR, Sivarajan K, Vineeta Gupta: A Microbiological study of anterior nasal packs in epistaxis. Indian Journal of Otolaryngology and Head and neck Surgery 1999, 15(1):42-46.