Seasonal variation and predictors of epistaxis

Laryngoscope. 2014 Sep;124(9):2028-33. doi: 10.1002/lary.24679. Epub 2014 Apr 29.


Objectives/hypothesis: To examine the incidence of epistaxis as a function of season and age and to determine predictors of episodes within the epistaxis patient population presenting to a tertiary hospital system.

Study design: Retrospective cohort study.

Methods: Electronic medical record charts of patients presenting to the Northwestern Emergency Department, admitted to an inpatient ward, or seen in an outpatient setting between 2008 and 2012 were reviewed and selected for an International Classifications of Disease-Ninth Revision epistaxis code of 784.7. Season of presentation, demographic factors (age, race, gender, insurance status), medication use (including anticoagulants and topical nasal steroid administration), and several comorbidities were analyzed as potential predictors of episodes.

Results: A total of 2,405 patients were identified with a total of 3,666 individual epistaxis episodes over 5 years. Multivariate analysis identified allergic rhinitis (AR), chronic sinusitis (CRS), coagulopathy, hereditary hemorrhagic telangiectasia (HHT), hematologic malignancy, and hypertension (HTN) as predictors of a higher number of cases. Epistaxis occurred more frequently during colder months and in older patients.

Conclusions: Epistaxis occurs more commonly during the winter and in older patients. AR, CRS, coagulopathy, HHT, hematologic malignancy, and HTN are associated with increased epistaxis incidence.

Keywords: Epistaxis; allergic rhinitis; chronic sinusitis; coagulopathy; epidemiology; hematologic malignancy; hereditary hemorrhagic telangiectasia; hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cohort Studies
  • Epistaxis / epidemiology*
  • Female
  • Forecasting
  • Humans
  • Incidence
  • Infant
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Seasons
  • Young Adult