The relationship between 100 cases of severe and recurrent epistaxis and long-term oral anticoagulants, age and hypertension

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Primary spontaneous epistaxis (n=100). Intervention: Long-term oral anticoagulants vs. Non-OAC users. Primary outcome: Severe epistaxis (OR 2.91, 95% CI 1.34-6.32, p=0.007).

Q: What does this research mean for the field?

Long-term use of oral anticoagulants independently increases the risk of severe and recurrent spontaneous epistaxis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Yuan Yang; Yu Huang

doi:10.1186/s13104-026-07979-0

August 11, 2026BMC Research NotesOpen Access

The relationship between 100 cases of severe and recurrent epistaxis and long-term oral anticoagulants, age and hypertension

View Full Paper

Ask AI

Bookmark

Share

Key result

Long-term OAC use linked to ~191% greater risk of severe epistaxis.

OR 2.91
95% CI 1.34-6.32
P=0.007
n=100

Why the study?

To explore the risk factors for severe and recurrent spontaneous epistaxis, including long-term oral anticoagulants, age, and hypertension.

Does long-term oral anticoagulation therapy increase the risk of severe and recurrent epistaxis in patients presenting with acute spontaneous epistaxis?

Key Points

To evaluate the risk factors for severe and recurrent spontaneous epistaxis, focusing on the roles of long-term oral anticoagulant use, age, and hypertension.
Conducted a single-center retrospective cohort study of 100 patients presenting with spontaneous primary epistaxis.
Categorized participants by long-term oral anticoagulant (OAC) therapy (n = 23 users vs. n = 77 non-users) and age groups (< 40, 40–70, and ≥ 70 years).
Applied multivariate logistic regression to evaluate the independent associations of OAC use, age ≥ 70 years, and hypertension with severe and 3-month recurrent epistaxis.
Severe epistaxis occurred in 52.17% (12/23) of OAC users compared with 23.38% (18/77) of non-OAC users (p = 0.003), while recurrent epistaxis within 3 months occurred in 43.48% (10/23) vs. 19.48% (15/77) (p = 0.008).
Multivariate logistic regression revealed that long-term OAC use (severe: OR = 2.91, 95% CI 1.34–6.32, p = 0.007; recurrent: OR = 2.69, 95% CI 1.23–5.93, p = 0.013) and age ≥ 70 years (severe: OR = 2.36, 95% CI 1.13–4.92, p = 0.022; recurrent: OR = 2.07, 95% CI 1.03–4.15, p = 0.042) were independent risk factors.
Hypertension was not independently associated with severe epistaxis (OR = 1.41, 95% CI 0.72–2.76, p = 0.312) or recurrent epistaxis (OR = 1.35, 95% CI 0.69–2.64, p = 0.375) after adjusting for covariates.

Study Design

Type

Cohort (n=100)

Multicenter

No

Structured PICO

Does long-term oral anticoagulation therapy increase the risk of severe and recurrent epistaxis in patients presenting with acute spontaneous epistaxis?

P

Population

100 patients aged 7 to 90 years with primary spontaneous epistaxis, followed for at least 3 months to assess severe and recurrent bleeding.

E

Exposure

Long-term oral anticoagulation (OAC) therapy (continuous and regular use for ≥ 3 months)

C

Comparator

No long-term OAC use

O

Outcome

Severe epistaxis (defined by posterior nasal bleeding, hemodynamic instability, a decrease in hemoglobin of ≥20 g/L, or the need for hospitalization, nasal packing, endoscopic electrocautery, arterial ligation, or embolization) and recurrent epistaxis (requiring outpatient, emergency, or re-intervention within 90 days)safety

Main Result

Odds Ratio: 2.91 (95% CI 1.34–6.32)

Absolute Event Rate: 52.17% vs 23.38%

p-value: p=0.007

Limitations

Lack of data on VKA/DOAC subtypes, doses, INR/TTR, or concurrent antiplatelet therapy
Unmeasured confounding factors such as NSAID use, smoking, and chronic sinusitis
Age modeled as a categorical rather than continuous variable, reducing statistical power
Small number of outcome events resulting in wide confidence intervals
Potential underestimation of mild recurrence events treated in the community
VKA/DOAC subtypes, doses, INR/TTR or concurrent antiplatelet therapy not recorded
Key unmeasured confounding factors (such as NSAIDs, smoking, chronic sinusitis) were missing
Age was modeled as categorical rather than continuous, reducing statistical power
Small number of outcome events (30 severe cases, 25 recurrent bleeding)
Underestimation of mild recurrence events treated in the community

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Long-term oral anticoagulant use and advanced age (≥70 years) are independent risk factors for severe and recurrent spontaneous epistaxis, highlighting the need for early screening and regular follow-up in this population.

Abstract

This single-center retrospective cohort study aimed to explore the risk factors for severe and recurrent spontaneous epistaxis, including long-term oral anticoagulants (OAC), age, and hypertension. Among the 100 participants, 23% were patients who had been using OAC for a long time. Compared with non-OAC users, the incidence of severe epistaxis in OAC users was significantly higher (52.17% [12/23] vs. 23.38% [18/77], p = 0.003), and the incidence of recurrent epistaxis within 3 months was also higher (43.48% [10/23] vs. 19.48% [15/77], p = 0.008). Multivariate logistic regression analysis confirmed that long-term use of OAC (severe epistaxis: relative risk ratio [odds ratios (OR)] = 2.91, 95% confidence interval [confidence intervals (CI)] 1.34–6.32, p = 0.007; recurrent epistaxis: OR = 2.69, 95% CI 1.23–5.93, p = 0.013) and age ≥ 70 years (severe epistaxis: OR = 2.36, 95% CI 1.13–4.92, p = 0.022; recurrent epistaxis: OR = 2.07, 95% CI 1.03–4.15, p = 0.042) were highly correlated with the occurrence of severe/recurrent epistaxis. After adjusting for covariates, hypertension did not show an obviously association with severe or recurrent epistaxis (all p > 0.05). In this study, diabetes, coronary heart disease, and cerebral infarction did not show a significant increase in bleeding risk.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Yang et al. (2026) conducted a cohort in Primary spontaneous epistaxis (n=100). Long-term oral anticoagulants vs. Non-OAC users was evaluated on Severe epistaxis (OR 2.91, 95% CI 1.34-6.32, p=0.007). Long-term use of oral anticoagulants independently increased the risk of severe epistaxis (OR 2.91) compared to non-users in patients presenting with spontaneous epistaxis.

synapsesocial.com/papers/6a7d768a2b0e0cff3f63ff0a https://doi.org/10.1186/s13104-026-07979-0

View Full Paper

Ask AI

Bookmark

Share

The relationship between 100 cases of severe and recurrent epistaxis and long-term oral anticoagulants, age and hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The relationship between 100 cases of severe and recurrent epistaxis and long-term oral anticoagulants, age and hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading