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Zhu B, Liu D, Lu X, Liu B, Guan B, Xu L. Relationship Between Environmental Meteorological Factors and the Incidence of Epistaxis in Different Age Groups in Yangzhou. EAR, NOSE & THROAT JOURNAL 2024:1455613241271680. [PMID: 39215480 DOI: 10.1177/01455613241271680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Objective: To investigate the relationship between environmental and meteorological factors and the incidence of epistaxis in different age groups in Yangzhou, as well as to provide a reference and theoretical basis for epistaxis prevention and treatment. Methods: The patients with epistaxis who were treated in Northern Jiangsu People's Hospital of Jiangsu Province from January 2016 to December 2020 were reviewed, and the relationship between the local environmental meteorological factors at the time of onset and the incidence of epistaxis in different age groups was analyzed, and the potential environmental meteorological risk factors of epistaxis in each age group were determined by Stepwise logistic regression. Results: From 2016 to 2020, there were 24,407 cases of epistaxis, mostly males and children. The effects of O3 concentration, average humidity, average temperature, NO2 concentration, sunshine duration, average wind speed, CO concentration, and temperature difference on the study population were statistically significant (P < .05). Analysis by age group showed that there were differences in environmental and meteorological factors related to epistaxis in different age groups. Conclusions: In Yangzhou, epistaxis is more prevalent among males and children. The environmental meteorological factors are related to the incidence of epistaxis in Yangzhou, among which the average humidity and temperature difference are negatively correlated with the incidence of epistaxis. In contrast O3 concentration, average temperature, NO2 concentration, sunshine duration, average wind speed, and CO concentration are positively correlated with epistaxis occurrence. However, the impact of these environmental and meteorological factors varies in different age groups.
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Affiliation(s)
- Bin Zhu
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Di Liu
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Xiuyue Lu
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Baoxu Liu
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Bing Guan
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Li Xu
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
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Zhu B, Chen C, Guan B, Xu L, Sun P. Relationship Between Air Pollutants and the Incidence of Epistaxis in Yangzhou. EAR, NOSE & THROAT JOURNAL 2024:1455613241249540. [PMID: 38738381 DOI: 10.1177/01455613241249540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Objectives: This project aims to explore the relationship between the air quality index (AQI), the concentration of 6 air pollutants, and the incidence of epistaxis in Yangzhou. Also, to provide reference information for the prevention and treatment of epistaxis. Methods: Data of patients with epistaxis admitted to the Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January 2017 to December 2021 were collected. In addition, the local AQI and the concentrations of 6 air pollutants, namely particulate matter (PM2.5, PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3), were analyzed at the time of onset. Furthermore, the correlation with the incidence of epistaxis has been analyzed. Results: From 2017 to 2021, there were 24,721 patients with epistaxis aged from 0 to 17 years old while male patients were more than females. The incidence was higher in April, May, and June. There was a statistically significant difference in the number of daily epistaxis in different months and under AQI conditions (P < .05). Spearman's correlation analysis showed that there was a positive correlation between the number of daily epistaxis and the concentrations of AQI, CO, NO2, O3, PM2.5, PM10, and SO2 in Yangzhou, in which O3, PM10, and SO2 were highly correlated with the average number of daily epistaxis, and there was no obvious time lag effect of air pollutants on epistaxis. Conclusion: Epistaxis in the Yangzhou area is more common in males, mostly occurs in 0 to 17 years old, with seasonal. There was also a positive correlation between the incidence of epistaxis and air pollutants in Yangzhou. Therefore, by reducing the AQI index in daily life, and reducing the concentration of environmental pollutants in the air, the occurrence of epistaxis could be prevented and reduced to a certain extent.
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Affiliation(s)
- Bin Zhu
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Chen Chen
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Bing Guan
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Li Xu
- Department of Otolaryngology, Head and Neck Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Pengfei Sun
- Department of Clinical Laboratory, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
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Gómez-Hervás J, Merino-Galvez E. Influence of meteorological variables on the frequency of visits and hospital admission for epistaxis in a city with a cold semi-arid climate (Lorca, Spain). Eur Arch Otorhinolaryngol 2024; 281:1307-1315. [PMID: 37898593 DOI: 10.1007/s00405-023-08300-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Epistaxis is a common emergency for otorhinolaryngologists. Although the aetiological factors have been widely studied, they remain subject to debate. The role of meteorological variables has been discussed in recent years, but results have been inconsistent. Given a lack of prior data, the aim of our study was to identify the meteorological variables that influence the frequency of visits and hospital admission for epistaxis in a city with a cold semi-arid climate in Spain. METHODS Case-control study. CASES patients who attended the accident and emergency department of a secondary level hospital for epistaxis over a 9-year period (2011-2019). Controls were established by simple random sampling among emergency rooms visits in general (patients who attended the same centre over the same period of time). Sociodemographic, clinical and meteorological variables were all taken into account. RESULTS 2749 patients in the epistaxis group and 2764 in the control group. There were significant differences in the epistaxis group, with a higher proportion of male (62.85%) and older patients. Univariate and multivariate analysis revealed that the daily minimum temperature and maximum wind speed were factors significantly associated with the onset of epistaxis. In addition, logistic regression analysis showed that decreases in minimum temperature and increases in maximum wind speed were associated with an increase in epistaxis (p < 0.01). No association was found between hospital admission and the weather conditions. CONCLUSION Our findings suggest that low minimum temperatures and high wind speeds are associated with the number of visits to hospital accident and emergency departments for epistaxis, but not with hospital admission.
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Affiliation(s)
- Javier Gómez-Hervás
- Hospital Universitario Rafael Méndez [Rafael Mendez University Hospital], Ctra. N-340, 30813, Lorca, Murcia, Spain.
| | - Esteban Merino-Galvez
- Universidad Católica San Antonio de Murcia [San Antonio Catholic University of Murcia, Guadalupe, Spain
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Wei EX, Green A, Chang MT, Hwang PH, Sidell DR, Qian ZJ. Environmental Risk Factors for Pediatric Epistaxis vary by Climate Zone. Laryngoscope 2024; 134:1450-1456. [PMID: 37589269 DOI: 10.1002/lary.30961] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/10/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION AND OBJECTIVE Prior studies have provided variable results regarding environmental risk factors for epistaxis. These studies were conducted in varying climate zones, which may explain discrepancies in results. The objective of this study is to investigate correlations between season, temperature, and humidity on frequency of pediatric epistaxis across climate zones. METHODS Children seen in the outpatient setting for epistaxis were identified from the 2007-2010 IBM MarketScan database. Climate zones were assigned according to International Energy Conservation Code (IECC) classification, where temperature zones in the United States and territories were assigned on an ordinal scale from 1 (tropical) to 8 (subarctic), and humidity zones were categorized as moist, dry, or marine. The control population was a sample of all well-child visits matched by age and county. RESULTS We identified 184,846 unique children seen for epistaxis and 1,897,012 matched controls. Moderate temperature zones were associated with lower odds of epistaxis compared with the hottest and coldest zones. Humidity was associated inversely with epistaxis rates in moderate temperature zones but was not a significant predictor of epistaxis in climates with extreme heat. Additionally, summer was associated with lower odds of epistaxis compared to winter. Interestingly, however, there were significantly higher rates of cautery procedures during summer months, driven largely by increased procedures performed in clinic, as opposed to the operating room or emergency room. CONCLUSIONS Environmental risk factors for epistaxis vary by climate zone. The model presented reconciles prior reports and may allow for more personalized clinical management based on regional climate. LEVEL OF EVIDENCE 3 Laryngoscope, 134:1450-1456, 2024.
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Affiliation(s)
- Eric X Wei
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Allen Green
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Michael T Chang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Peter H Hwang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Douglas R Sidell
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Z Jason Qian
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
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Yusuf HM, Rasheed A, Hetts S, Kim H, Loftus P, Conrad M. Exploring effects of atmospheric conditions in hereditary hemorrhagic telangiectasia. Int Forum Allergy Rhinol 2023; 13:2172-2179. [PMID: 37189284 DOI: 10.1002/alr.23183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder characterized by recurrent epistaxis, telangiectasias, and visceral arteriovenous malformations. Individuals with HHT often identify low humidity and temperature as detrimental to epistaxis severity. We set out to assess the relationship between humidity and temperature on epistaxis severity in patients with HHT. METHODS Retrospective cross-sectional study at an academic hospital with an HHT center between July 1, 2014 and January 1, 2022. The primary outcome of this study was ESS. Pearson correlation analyses and multiple linear regression analyses were performed to test the association between weather variables and epistaxis severity scre (ESS). Results were reported as coefficient and 95% confidence interval (CI). RESULTS Four hundred twenty-nine patients were included in the analysis. Through a Pearson correlation analysis, neither humidity (regression coefficient = -0.01; 95% CI, -0.006 to 0.003; p = 0.50), daily low temperature (regression coefficient = 0.01; 95% CI, -0.011 to 0.016; p = 0.72), or daily high temperature (regression coefficient = 0.01; 95% CI, -0.004 to 0.013; p = 0.32) were significantly correlated with ESS. In a multiple linear regression analysis, adjusting for both daily low temperature and humidity, medications taken, demographics, and genotype, neither daily low temperature (regression coefficient = -0.02; 95% CI, -0.04 to 0.01; p = 0.14) nor humidity (regression coefficient = 0.01; 95% CI, -0.01 to 0.01; p = 0.64) were significantly associated with ESS. CONCLUSION We have shown in a large clinical sample that neither humidity nor temperature were strongly correlated with HHT patient epistaxis severity.
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Affiliation(s)
- Hamzah M Yusuf
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Amna Rasheed
- Touro College of Medicine, Vallejo, California, USA
| | - Steven Hetts
- Neurointerventional Radiology, University of California, San Francisco, California, USA
| | - Helen Kim
- Center for Cerebrovascular Research, University of California, San Francisco, California, USA
| | - Patricia Loftus
- Otolaryngology, University of California, San Francisco, California, USA
| | - Miles Conrad
- Radiology, School of Medicine, University of California San Francisco, San Francisco, California, USA
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Matsumoto S, Ishii R, Kiuchi C, Osawa K, Adachi M, Ii R, Nakayama M, Tanaka S, Tabuchi K. Effect of Average Relative Humidity on Epistaxis. Cureus 2023; 15:e36063. [PMID: 37056533 PMCID: PMC10092054 DOI: 10.7759/cureus.36063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2023] [Indexed: 03/18/2023] Open
Abstract
Background Epistaxis is a very common symptom. The occurrence of epistaxis may be affected by dry environments, but there are some differences among previous reports and this view is controversial. Objective We investigated the relationship between the number of epistaxes and daily average relative humidity. Methods Data on patients with epistaxis between March 2011 and February 2021 were collected from two hospitals. The daily average relative humidity was examined, and the change in the number of patients with epistaxis due to humidity was investigated using a generalized linear mixed model. Results A total of 4184 cases of epistaxis were identified. The number of epistaxis cases per day was significantly associated with the daily average relative humidity (p < 0.001). One percent increment in average relative humidity decreases the number of epistaxis cases per day by 1.1%. Conclusion A negative correlation was found to exist between daily average relative humidity and occurrences of epistaxis.
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Ahn EJ, Min HJ. Age-specific associations between environmental factors and epistaxis. Front Public Health 2022; 10:966461. [PMID: 36339143 PMCID: PMC9626808 DOI: 10.3389/fpubh.2022.966461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Several studies have demonstrated that environmental factors, such as meteorological factors and air pollutants, are closely associated with epistaxis. However, age-specific associations between environmental factors and epistaxis have not yet been evaluated. This study aimed to evaluate the associations between individual meteorological factors and air pollutants and epistaxis, by age. Study design A retrospective cohort study. Setting Records of patients covered by the Korean National Health Insurance Service who visited our hospital for epistaxis between January 1, 2002, and December 31, 2015, were retrospectively reviewed. Methods The 46,628 enrolled patients were divided into four age groups: age group 0 (<18 years, N = 19,580); age group 1 (18-40 years, N = 10,978); age group 2 (41-70 years, N = 13,395); and age group 3 (>70 years, N = 2,675). Cases of epistaxis and data on environmental factors were analyzed according to the day, month, and year. Stepwise logistic regression was performed to identify the environmental risk factors for epistaxis in each age group. Results Age group 0 had the highest number of patients with epistaxis, whereas age group 3 had the lowest. Relative humidity, temperature, concentrations of particulate matter (PM10) and sulfur dioxide, sunshine duration, and wind speed were significantly associated with the occurrence of epistaxis in the study population. However, analysis according to age group showed that the meteorological factors and air pollutants associated with epistaxis were different in each age group. Conclusion We suggest that the environmental risk factors for epistaxis should be differentially analyzed according to age.
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Affiliation(s)
- Eun-Jin Ahn
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea,*Correspondence: Hyun Jin Min
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