Evaluation of the Management in the Epistaxis cases in a Reference Hospital in the South of Brazil
- 1. Universidade do Sul de Santa Catarina, Brazil
Introduction: Epistaxis is defined as bleeding from the nasal mucosa. It is estimated that at least 60% of adults have already had an episode of epistaxis, being more common in men. Objective: Analyze the management (therapy) and epidemiological profile of patients admitted to Hospital Nossa Senhora da Conceição (HNSC) in Tubarão, Santa Catarina, Brazil.
Methods: Cross-sectional study that included HNSC patients with complaints of epistaxis in the period from 2010 to 2017. Data were obtained from medical records of the TASY software and inserted in a collection instrument structured by the researchers.
Results: Study with 704 patients, 290 women and 414 men, with an average age of 44.6 years. It was observed that 49.7% of them had some comorbidity, and that of these, 5.1% used inhibitors of platelet aggregation and 2.3% anticoagulants. Still, 30% of the patients presented
hypertensive crisis associated with epistaxis, being more common over 60 years of age (p <0.001). During the study it was observed that the majority of cases occurred in winter (32.9%), and that most patients (86.1%) were not submitted to hospitalization. Regarding medical care,
only 20.7% needed the care of an otolaryngologist. Complementary exams were also performed in the minority (31.7%). Patients over 60 years of age were those who most used the tampon as a therapeutic option. On the other hand, cauterization was more chosen between the ages of 20 and 59 and the only ligation was also performed in this age group. Finally, expectant management was superior in individuals under 12 years old. Recurrence was observed in 31.3% of patients regardless of the management chosen.
Discussion: Epistaxis is more common in men and in cold climates. It has a multifactorial etiology and usually originates in the Kisselbach plexus. Most of them are usually benign and self-limited, not requiring hospitalization, complementary exams or surgical procedures, such as
surgical ligation and electrical cauterization.
Conclusion: The most used management was nasal packing followed by the expectant, cauterization and ligation respectively .