The goal of this study was to evaluate independent risk factors for long-term epistaxis recurrences and their severity. Individual retrospective cohort study-2b level of evidence. The medical information of 603 emergency epistaxis patients was acquired during a former study. This cohort has been contacted 6 years later by conventional mail and asked to answer a specific paper questionnaire. The following parameters were evaluated: recurrent epistaxis episodes, need for a surgical intervention to stop the recurrent bleeding, patient's history for hypertension and diabetes, intake of hemostasis impairing medication now and in the past. One hundred and six (106) patients were included in the study (35.8 % response rate). The mean observation period was 76.58 months. Almost half of the patients (41.5 % = 44/106) reported at least one recurrent epistaxis episode. Patients with exposure to VKA (vitamin K antagonists) showed significantly more frequently a recurrent epistaxis episode. The binary logistic regression confirmed the intake of VKA as an independent and significant risk factor with an odds ratio of 11.6. Every single patient who had to undergo a surgical intervention to stop a recurrent bleeding stated ASA (Acetylsalicylic Acid) intake. We provide evidence that the intake of a vitamin K antagonist is an independent long-term risk factor for recurrent epistaxis episodes. The intake of ASA is a risk factor for the severity of recurrent epistaxis with the increased need for a surgical intervention not only in a short-but also in a long-term perspective. Level of evidence: This prognostic investigation, designed as a combined prospective and retrospective cohort study, reaches level 2b level of evidence as it includes retrospective aspects.
Objectives/Hypothesis 7The goal of this study was to evaluate independent risk factors for long-term epistaxis 8 recurrences and their severity. 9
Study design 10Individual retrospective cohort study -2b level of evidence. 11
Methods 12The medical information of 603 emergency epistaxis patients was acquired during a 13 former study. This cohort has been contacted six years later by conventional mail 14 and asked to answer a specific paper-questionnaire. The following parameters were 15 evaluated: Recurrent epistaxis episodes, need for a surgical intervention in order to 16 stop the recurrent bleeding, patient's history for hypertension and diabetes, intake of 17 hemostasis impairing medication now and in the past. 18
Results 19One hundred and six (106) VKA as an independent and significant risk factor with an odds ratio of 11.6. Every 25 single patient who had to undergo a surgical intervention in order to stop a recurrent 26 bleeding stated ASA (Acetylsalicylic Acid) intake. 27 2
Conclusion 28We provide evidence that the intake of a vitamin K antagonist is an independent 29 long-term risk factor for recurrent epistaxis episodes. 30The intake of ASA is a risk factor for the severity of recurrent epistaxis with the 31 increased need for a surgical intervention not ...
