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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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Lucas JP, Shaffer A, Rushchak M, Stapleton A, Padia R. Environmental impact on pediatric epistaxis and the utility of diagnostic studies: A single-institutional review. Int J Pediatr Otorhinolaryngol 2024; 176:111827. [PMID: 38128356 DOI: 10.1016/j.ijporl.2023.111827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/23/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Pediatric epistaxis is a multifactorial disease entity. The objective of this study is to determine the socioeconomic and air-quality contributions to pediatric epistaxis. The study also evaluates the utility of diagnostic lab work as a predictor of bleeding rates and need for operative intervention. METHODS A case series of pediatric patients treated in an outpatient Otolaryngology clinic at a tertiary care children's hospital in 2021 for epistaxis was performed. Patients with nasal bone trauma (n = 8), consult while inpatient (n = 7), and those with nasal masses (n = 2) were excluded; 181 patients met inclusion criteria. Demographic, clinical, socioeconomic, and air quality (tropospheric ozone, particulate matter) data were recorded. Associations with persistent bleeding and operative interventions were evaluated using logistic regression, Wilcoxon rank-sum, and Spearman rank correlation. RESULTS Of the 181 patients, 75 (41.4%) were female. Forty-six of 181 (25.4%) had associated allergic symptoms. Twenty-six patients had allergy testing; 14/26 (53.8%) of these had positive results. Re-bleeding was more common in those with allergic symptoms (OR: 2.42, 95% CI: 1.22-4.78, p = 0.01). Patients with re-bleeding lived in counties with more days with ozone over the US standard (median 5 days, range 0-32 days) compared with those with no re-bleeding (median 3 days, range 0-32 days, p = 0.007). There was also an association between the number of visits for re-bleed and percent below poverty level (ρ = 0.259, p = 0.03) as well as the number of days with particulate matter levels over the US standard (ρ = 0.343, p = 0.01). Coagulopathy was present in 9/54 (16.7%) patients, with the majority being Von Willebrand disease (5/54, 9.3%). Easy bruising was not significantly associated with positive lab results. CONCLUSIONS Environmental pollution, living in a zip code with more residents below the poverty level, and allergic rhinitis were positively associated with recurrent epistaxis. Understanding the geographic background of presenting patients may help direct workup and treatment options.
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Affiliation(s)
- Jordyn P Lucas
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA, 15224, United States; Department of Otolaryngology, University of Pittsburgh School of Medicine, United States; Eastern Virginia Medical School, Department of Otolaryngology, 600 Gresham Dr. #1100, Norfolk, VA, 23507, United States; Children's Hospital of the King's Daughter, Department of Pediatric Otolaryngology, 601 Children's Lane, Norfolk, VA, 23507, United States.
| | - Amber Shaffer
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA, 15224, United States; Department of Otolaryngology, University of Pittsburgh School of Medicine, United States
| | - Marina Rushchak
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA, 15224, United States; Department of Otolaryngology, University of Pittsburgh School of Medicine, United States
| | - Amanda Stapleton
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA, 15224, United States; Department of Otolaryngology, University of Pittsburgh School of Medicine, United States
| | - Reema Padia
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA, 15224, United States; Department of Otolaryngology, University of Pittsburgh School of Medicine, United States; University of Utah, Department of Otolaryngology, Primary Children's Hospital, 100 Mario Capecchi Dr, Salt Lake City, UT, 84113, United States
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Qing J, Cai Y, Tang S, Wang Y. Clinical Characteristics and Risk Factors for Allergic Rhinitis in Children with Epistaxis. Int J Clin Pract 2023; 2023:6731414. [PMID: 37691857 PMCID: PMC10484648 DOI: 10.1155/2023/6731414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/02/2023] [Accepted: 08/19/2023] [Indexed: 09/12/2023] Open
Abstract
Background Epistaxis is frequently observed in children with allergic rhinitis. However, few studies have addressed the clinical characteristics and risk factors for allergic rhinitis in children with epistaxis. This study aimed to describe the factors associated with allergic rhinitis in children with epistaxis. Methods In total, we recruited 80 children (aged 3-14 years) who presented with epistaxis at a tertiary hospital between January 2014 and January 2022. The follow-up duration was at least 3 months, and we performed a multivariate logistic regression analysis to identify the risk factors for allergic rhinitis. Results Among the 80 children examined, 57 (71.25%) had allergic rhinitis. Epistaxis mainly occurred in autumn in children with allergic rhinitis; in contrast, it mostly occurred in summer in children without it (P = 0.029). Mites are common allergens for allergic rhinitis in children with epistaxis; the univariate analysis revealed significant differences between allergic-rhinitis group and nonallergic-rhinitis group in the number of allergens (P < 0.001) and total IgE (P < 0.001). The difference in severity of nasal symptoms between the two groups was statistically significant and included nasal obstruction (P < 0.001), rhinorrhea (P < 0.001), sneezing (P < 0.001), and nasal itching (P < 0.001). After adjusting for potential confounders, the severity of rhinorrhea symptoms was found to be associated with an increased risk of allergic rhinitis in children with epistaxis (odds ratio: 3.86; 95% confidence interval: 1.61-9.26; P = 0.003). Conclusions Observing the onset season, number of allergens, total IgE, and nasal symptoms in cases of epistaxis could suggest the presence of associated allergic rhinitis and reduce the number of missed diagnoses; antiallergic drugs could help control epistaxis in these cases.
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Affiliation(s)
- Jing Qing
- Department of Otorhinolaryngology, Ningbo First Hospital, Ningbo 315000, Zhejiang, China
| | - Yili Cai
- Department of Acupuncture, Ningbo First Hospital, Ningbo 315000, Zhejiang, China
| | - Shixiong Tang
- Department of Otorhinolaryngology, Ningbo First Hospital, Ningbo 315000, Zhejiang, China
| | - Yaowen Wang
- Department of Otorhinolaryngology, Ningbo First Hospital, Ningbo 315000, Zhejiang, China
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Ahn EJ, Min HJ. Environmental factors differentially affect epistaxis among preschool and school-aged children. Front Public Health 2023; 11:1178531. [PMID: 37621609 PMCID: PMC10446964 DOI: 10.3389/fpubh.2023.1178531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction Environmental factors are closely associated with pediatric epistaxis. Whether this association differs according to age has not been previously reported. Therefore, we tried to evaluate the differences in associations between environmental factors and epistaxis in children of different ages. Methods A total of 20,234 patients with epistaxis who visited the hospital between January 1, 2002, and December 31, 2015, were enrolled in this study. The patients were divided into two groups according to their ages: preschool-aged (<6 years) and school-aged children (6-18 years). Daily, monthly, and yearly data on environmental factors were collected. We performed a stepwise logistic regression to identify the potential environmental risk factors for epistaxis in each age group. Results The mean number of epistaxis cases per month in both groups was highest in September. The cases were lowest in February in preschool-aged children and in November in school-aged children. Temperature, humidity, maximum wind speed, and sunshine duration were associated with epistaxis in preschool-aged children. Average wind speed, particulate matter (>10 μm diameter), temperature, humidity, sunshine duration, and sulfur dioxide concentration were associated with epistaxis in school-aged children. Conclusion This study indicates that the differences in environmental risk factors for epistaxis are associated with the patient's age.
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Affiliation(s)
- Eun-Jin Ahn
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University, Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
- Biomedical Research Institute, Chung-Ang University Hospital, Seoul, Republic of Korea
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Differential effect of meteorological factors and particulate matter with ≤ 10-µm diameter on epistaxis in younger and older children. Sci Rep 2022; 12:21029. [PMID: 36470979 PMCID: PMC9723103 DOI: 10.1038/s41598-022-25630-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
The differential effect of meteorological factors and air pollutants on pediatric epistaxis in younger and older children has not been evaluated. We evaluated the distribution of pediatric epistaxis cases between younger (0-5 years) and older children (6-18 years). Subsequently, we assessed and compared the effects of meteorological variables and the concentration of particulate matter measuring ≤ 10 μm in diameter (PM10) on hospital epistaxis presentation in younger and older children. This retrospective study included pediatric patients (n = 326) who presented with spontaneous epistaxis between January 2015 and August 2019. Meteorological conditions and PM10 concentration were the exposure variables, and data were obtained from Korea Meteorological Administration 75. The presence and cumulative number of epistaxis presentations per day were considered outcome variables. Air temperature, wind speed, sunshine duration, and PM10 concentration in younger children, and sunshine duration and air pressure in older children, significantly correlated with the presence of and cumulative number of epistaxis presentations per day. The PM10 concentration was not a significant factor in older children. Thus, meteorological factors and PM10 concentration may differentially affect epistaxis in younger (0-5-year-olds) and older (6-18-year-olds) children. Risk factors for pediatric epistaxis should be considered according to age.
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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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