Epistaxis in geriatric patients

Authors: ALPER YÜKSEL, HANİFİ KURTARAN, EKREM SAİD KANKILIÇ, NEBİL ARK, KADRİYE ŞERİFE UĞUR, MEHMET GÜNDÜZ

Abstract: Epistaxis is a common emergency in otolaryngology. The aim of this study is to analyze the etiology, management, and accompanying disorders of epistaxis in geriatric patients by reviewing the literature Materials and methods: Data of 117 patients 65 years old and older who presented to the Department of Otorhinolaryngology with active epistaxis between 2004 and 2010 were retrospectively reviewed. Records were evaluated for age, sex, accompanying disorders, drug medication, detailed otorhinolaryngological findings, and management of epistaxis. Results: There were 67 women (57.26%) and 50 men (42.74%) with a mean age of 73.51 years (range: 65–90). Ninety-four (80.34%) patients had accompanying disorders such as hypertension, diabetes mellitus, cerebrovascular disease, sinusitis, chronic obstructive lung disease, nasal polyp, and drug treatment. The bleeding site was anterior in 90 patients (76.92%) and posterior in 16 (13.67%). In 11 patients (9.4%), the bleeding site was not identified. Fifty-seven patients (48.71%) were treated with cauterization, 17 patients (14.52%) with nasal packing, 12 patients (10.25%) with medical treatment, 1 patient (0.85%) with mass excision and nasal packing, and 19 patients (16.23%) with more than 1 treatment method. Six patients (5.12%) were untreated because of the unidentified bleeding point. Bleeding control was performed under local anesthesia in 113 patients (96.58%) and under general anesthesia in 4 patients (3.41%). Twenty-one patients (17.94%) were hospitalized and 3 patients (2.56%) required a blood transfusion. Conclusion: Epistaxis is the most common otorhinolaryngological emergency. It must be evaluated carefully to avoid the potential complications resulting from both epistaxis and its associated disorders, especially in geriatric patients.

Keywords: Epistaxis, cauterization

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