Epistaxis in a 12-year Case Series at a University Hospital

To review the etiology, management, and outcomes of patients admitted with epistaxis at a single tertiary hospital. A retrospective review was conducted on patients admitted with epistaxis to a University Hospital from January 2007 to December 2019. Cases were drawn from the Departments of Otolaryngology, Internal Medicine, Pediatrics, and Surgery. Etiologies were categorized as local or systemic. A total of 295 patients were identified, most from Otolaryngology (78.6%). Causes were determined in 82.0% of all cases. Among the 232 Otolaryngology patients, the mean age was 49.6 ± 17.2 years, and 69.8% were male. Etiologies were identified in 75.9%, with hypertension being the most common (25.9%); sinonasal malignancies accounted for 10.3%. Bleeding was managed stepwise using nasal packing, endoscopic cauterization, sphenopalatine cauterization, angiography, and embolization. Endoscopic procedures were performed in 57.7%, while angiographic embolization was required in 0.9%. Patients with heart disease were less likely to undergo surgery. This study provides a comprehensive overview of epistaxis management in a tertiary care setting. Hypertension was identified as the most common underlying cause, and a structured stepwise approach resulted in successful bleeding control in all cases. Endoscopic surgical intervention was required in 57.7% of patients, underscoring its important role in the management of moderate to severe or recurrent epistaxis.