Comparison of Anterior and Posterior Hemorrhages in Patients Presenting to the Emergency Department with Epistaxis

Abstract

Objective: Epistaxis has still not lost its importance because it is a common problem in our country as well as in the world, and it rarely requires emergency service admission.. Many factors are involved in the etiology. Many variables such as changing environmental factors, patient characteristics (additional disease history, drug use, etc.) and laboratory values make each epistaxis patient unique. In our study, population-based data on cases requiring outpatient and inpatient treatment in patients who applied to our emergency department with epistaxis were determined and their contribution to emergency department management was investigated. Material and Methods: Patients admitted to the emergency department with epistaxis; Demographic characteristics, comorbidities, hemodynamic and laboratory parameters at admission, need for specialist consultation and outpatient/inpatient treatment needs were evaluated retrospectively. Results: İn our study were included a total of 115 patients, 69 (60%) male and 46 (40%) female. The mean age of these patients was 55,4 (±19,1) years. No statistically significant difference was found between patients presenting with anterior or posterior bleeding in comorbid diseases and drug use history. The hospitalization rate of patients with posterior bleeding was 63,6% (n=14), and this rate was 36,4% in anterior hemorrhages. This difference was also statistically significant (p<0,001). When laboratory parameters are evaluated; neutrophil count (p=0,015), lymphocyte count (p=0,008), platelet lymphocyte ratio (PLR) (p=0,000), neutrophil lymphocyte ratio (NLR) (p=0,003) were also found to be statistically increased in posterior hemorrhages. Conclusion: In the results of this study, neutrophil, lymphocyte, PLR and NLR values, which are inflammatory markers; significant increase in posterior hemorrhages indicate that inflammatory factors have an effect on posterior hemorrhages.

Keywords

• epistaxis
• emergency department
• anterior bleeding
• posterior bleeding
• neutrophil-lymphocyte ratio
• platelet-lymphocyte ratio

Acil Servise Epistaksis İle Başvuran Hastalarda Anterior Ve Posterior Kanamaların Karşılaştırılması

Abstract

Amaç: Epistaksis, dünya genelinde olduğu gibi ülkemizde de yaygın bir sorun olması bununla birlikte nadiren acil servis başvurusu gerektirmesi nedeniyle halen önemini kaybetmemiştir. Etiyolojide birçok faktör yer almaktadır. Değişen çevresel etkenle, hasta özellikleri (ek hastalık öyküsü, ilaç kullanımı vb.) ve laboratuvar değerleri gibi birçok değişken her epistaksis hastasını kendine özgü kılmaktadır. Çalışmamızda acil servisimize epistaksis ile başvuran hastalarda ayaktan ve yatarak tedavi gerektiren vakalar hakkında popülasyona dayalı veriler belirlenerek acil servis yönetimine katkısı araştırıldı. Gereç ve Yöntemler: Acil servise epistaksis ile başvuran hastaların; demografik özellikleri, komorbiditeleri, başvuru anındaki hemodinamik ve laboratuvar parametreleri, uzman konsültasyon ihtiyacı ve ayaktan/yatarak tedavi ihtiyaçları retrospektif olarak değerlendirildi. Bulgular: Çalışmaya 69’u (%60) erkek, 46’sı (%40) kadın toplam 115 hasta dahil edildi. Bu hastaların yaş ortalaması 55,4 (±19,1)yıldı. Komorbid hastalıkların ve ilaç kullanım öyküsünün, anterior veya posterior kanamayla başvuran hastalar arasında istatistik olarak anlamlı bir fark yaratmadığı saptanmadı. Posterior kanaması olan hastaların yatış oranı %63,6 (n=14), anterior kanamalarda bu oran %36,4 olarak saptandı. Bu fark istatistiksel olarak da anlamlı bulunmuştur (p<0,001). Laboratuvar parametreleri değerlendirildiğinde; nötrofil sayısı (p=0,015), Lenfosit sayısı (p=0,008), platelet lenfosit oranı (PLR) (p=0,000), nötrofil lenfositoranı (NLR) (p=0,003) posterior kanamalarda istatistiksel olarak da anlamlı şekilde artmış saptandı. Sonuç: Bu çalışmanın sonuçlarında inflamatuar belirteçler olan nötrofil, lenfosit, PLR ve NLR değerlerinin; posterior kanamalarda anlamlı şekilde artması, inflamatuar faktörlerin posterior kanamalarda etkisi olduğunu göstermektedir.

Keywords

• epistaksis
• acilservis
• anteriorkanama
• posteriorkanama
• nötrofillenfositoranı
• trombositlenfositoranı

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