- 期刊
- OpenAccess
Evaluation of the Relationship Between Blood Pressure Control and Epistaxis Recurrence After Achieving Effective Hemostasis in the Emergency Department
摘要
Background: Epistaxis is the most common cause of otorhinolaryngologic emergencies. There is a longstanding controversy regarding the relationship between epistaxis and hypertension (HTN), in terms of blood pressure (BP) control in the emergency department (ED) setting. The objective of this study is to evaluate the association between HTN, BP control, and recurrent epistaxis among patients initially admitted to the ED for epistaxis. Methods: This retrospective cohort study was conducted in the EDs of three different hospitals in Taiwan and included a total of 739 patients admitted for epistaxis. Results: Among ED patients with epistaxis, older age was significantly associated with a history of HTN, and a statistically significant difference in age was noted between groups classified according to the systolic BP/diastolic BP (SBP/DBP) at triage. Patients with a history of HTN had higher BP values at triage than did patients without a history of HTN (SBP: 175.68 ± 32.30 mmHg vs. 148.00 ± 26.26 mmHg, DBP: 95.04 ± 20.98 mmHg vs. 83.30 ± 16.65 mmHg; p ＜ 0.0001). Antihypertensive medications were more commonly administered to patients with a history of HTN (p ＜ 0.0001) and in those patients with SBP/DBP: ≥ 140/≥ 90 mmHg at triage (p ＜ 0.0001). Among patients receiving antihypertensive medications, reductions in SBP by the time of discharge were significantly greater in patients with a history of HTN and in patients with SBP/DBP: ≥ 160/≥ 100 mmHg at triage. ED revisits due to recurrent epistaxis within 72 hours were significantly associated with male sex, a positive history of HTN, level of GOT, observation for recurrent epistaxis at ED, and duration of recurrent bleeding. Conclusion: A positive history of HTN is related to recurrent epistaxis among ED patients. The effectiveness of administering antihypertensive agents before achieving hemostasis in patients admitted to the ED for epistaxis warrants further study.
延伸閱讀
- 李福莉、鍾玉珠、何雪華、古雪鈴（2005）。The Effects of Rewarming Strategy on Patients Receiving Abdominal Surgery during Intraoperative Phase in Prevention Core Hypothermia and Postanesthetic Recovery。慈濟護理雜誌，4(1)，42-50。https://doi.org/10.6974/TCNJb.200503.0042
- 殷嘉駿（2021）。Study on the Relationship between the Stenosis Degree and Blood Flow Sound of the Vascular Access Using an Experimental Model of Extracorporeal Vascular Access〔碩士論文，義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-0202202111102000
- Wang, Y. M., Lin, S. M., Wang, C. J., Lin, T. Y., Kuo, H. P., & Lin, H. C. (2006). The Diagnosis and Clinical Outcomes of Patients with Sepsis-induced Disseminated Intravascular Coagulation in a Medical Intensive Care Unit. 胸腔醫學, 21(2), 157-167. https://doi.org/10.29806/TM.200604.0004
- 劉毅（1984）。The Combined Use of Tourniquet Hemostasis and Pressure Hemostasis in Operations of Hand Surgery – A Clinical Application of a simple but Effective Hemostatic Method in Surgery of Extremities –。Journal of Orthopaedic Surgery Taiwan，1(2)，50-53。https://www.airitilibrary.com/Article/Detail?DocID=10116923-198406-1-2-50-53-a
- Musallam, K. M., Jamali, F. R., Rosendaal, F. R., Richards, T., Spahn, D. R., Khavandi, K., Barakat, I., Demoss, B., Lotta, L. A., Peyvandi, F., & Sfeir, P. M. (2013). Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting. Anemia, 2013(), 16-22. https://doi.org/10.1155/2013/206829