Study Examines Various Treatments for Nose Bleeds

The way doctors treat nose bleeds (epistaxis), a condition that will affect about 60 percent of the population during their lifetime, varies greatly among patients seeking medical attention with no difference in outcomes, according to a study by Jennifer A. Villwock, M.D., and Kristin Jones, M.D., of the State University of New York-Upstate Medical University, Syracuse.

About 70 percent of nose bleeds occur spontaneously for reasons that range from unknown causes to cancerous lesions. While about 6 percent of patients with nose bleeds will require medical or surgical attention, very few people (less than 0.2 percent) will need to be hospitalized with a bleeding nose, according to the study background.

Researchers identified 57,039 cases of nose bleeds from 2008 to 2010. Of those patients, 21,872 patients (38.3 percent) were treated conservatively; 30,389 (53.3 percent) received nasal packing or cauterization;  2,706 (4.7 percent) underwent arterial ligation (tying of a blood vessel); and 1,956 (3.4 percent) underwent embolization (sealing off a bleeding blood vessel), according to the study findings. The odds of having a stroke were higher for patients who underwent embolization than nasal packing, a difference researchers suggest may be due to disease severity. Embolization also had the highest hospital costs.

“Further prospective studies are needed to elucidate variables affecting outcomes of the various treatment options for epistaxis,” the study concludes.

(JAMA Otolaryngol Head Neck Surg. Published online October 17, 2013. doi:10.1001/jamaoto.2013.5220.