Is a Laboratory Evaluations Required in Every Case Admitting to the
Pediatric Emergency Department with Epistaxis?
Abstract
ABSTRACT Background: Epistaxis is a mostly self-limiting condition
common among children and is rarely severe. In this study, it was aimed
to evaluate the incidence, demographic characteristics, causes of
bleeding and treatment methods of patients who applied to the Pediatric
Emergency Department (PED) with epistaxis, and to determine in which
cases a laboratory test should be used. Method: Admitted to Gazi
University Faculty of Medicine, PED which provides trauma care and is a
tertiary hospital, between January 1, 2019 and December 31, 2019, 452
patients aged 0-18 years who presented with epistaxis to any reason or
secondary to systemic disease were analyzed retrospectively. Results:
The annual incidence was found 1.23%. The median age was 63 months, 258
of the cases (57.1%) were male. It was found that the cases most
frequently applied to the hospital in the autumn months (37.6%). Sixty
of the patients (13.3%) had a chronic disease and 54 (11.9%) had a
history of drug use. Bleeding time was less than 5 minutes in 75.2% and
84.4% of the bleeding was unilateral. Nasal bleeding is local in
73.4%; 4.7% of them developed due to systemic reasons. The most common
cause of epistaxis; while they were trauma at the first 10 years of age,
they were idiopathic causes after the age of 10 years. In 434 (96%) of
the patients, epistaxis spontaneously stopped and there was no need for
additional treatment. Conclusion: As a result of this study, it was
concluded that laboratory tests should be performed in cases with
chronic disease history, bilateral bleeding, active bleeding and
nontraumatic epistaxis. The situation that causes epistaxis in the
childhood age group should be determined with a good history and
physical examination, laboratory tests should not be used in every
patient. Key Words: pediatric emergency, epistaxis, laboratory
examinations, complete blood count