Challenges in the Management of Epistaxis with Limited Resources Pondicherry India, 2016

Challenges in the management of Epistaxis with limited resource, Pondicherry India, 2016 Background. Epistaxis is a challenging and common condition. The lifetime incidence of epistaxis is difficult to determine. The management of epistaxis has evolved significantly in recent years. This study was conducted with limited resource to identify the etiological profile and to determine outcome of treatment of these patients Methods We conducted cross sectional survey among epistaxis patients attending health facilities using convenient sampling. Initial assessment includes haemodynamic status, type and severity of bleeding. All patients underwent radiological evaluation and Diagnostic nasal endoscopic (DNE). All patients were initially treated conservatively and surgical intervention is considered only when conservative means failed . Systemic and local risk factor estimation was done in a comprehensive examination. .Univariate and stepwise regression analyses were done to identify the independent risk factors associated with the presence and severity of epistaxis. We calculated adjusted odds ratio with 95% CI to identify the factors associated with diabetic retinopathy. Results The prevalence of epistaxis was 1.4% in the study population. It was more common among males. The commonest age group effected was more in the fourth decade of life. The commonest etiological factor was trauma (43.2%), hypertension (23.5%), infectious conditions (11.7%), D.N.S. with spur (8%) ,nasal polyp (7.4) and idiopathic causes (6.2%) . The causes for epistaxis in the first and second decades were trauma, infection and septal abnormalities. Conclusion Most of the underlying causes of epistaxis are preventable. A clearer understanding of the causes, treatment and outcome of these patients is essential for establishment of preventive strategies as well as treatment guidelines