Epistaxis: Prevalence and severity among Hypertensive patients attending District hospital in Tanzania

Abstract

Background: Epistaxis is one of the common ENT emergency conditions. Most of the time the bleeding is self-limited, but can be life-threatening. Serious spontaneous epistaxis may reveal underlying true hypertension in about 43% of patients with no previous history of hypertension. It can result from several causes and hypertension is among the aggravating factors.

Objective: The study aimed to determine the prevalence and severity of epistaxis among hypertensive patients.

Material and method: This study was a prospective cross-sectional study conducted from October 2021 to April 2022 involving a total of 196 adult patients with hypertension at a district hospital in Tanzania. A consecutive sampling technique was employed and structured questionnaires were used to collect data. Data entry was performed using SPSS version 25 and a P value of <0.05 was considered statistically significant.

Result:196 patients aged above 30 years were recruited, the majority of the patients were females (63%) and males were only (37%). The Prevalence of epistaxis was found to be lower among patients with hypertension aged below 40 years which accounted for 4.2%.However, patients aged 51-60 had a high prevalence of epistaxis (41.7%). The overall prevalence of epistaxis among hypertensive patients was found to be (12.2%) of which (62.5%) were females and (37.5%) were males. Furthermore, in this study, it was found that the severity of epistaxis among hypertensive patients was mild to moderate with (2%) of patients who required nasal packing. In this study (1%) of patients had mild epistaxis and (2%) had moderate epistaxis but no patients were found to have severe epistaxis as per epistaxis severity score (ESS) by Jeffrey B. Hoag (Score tool).

Conclusion and recommendation: Epistaxis can result from several local and systemic conditions. Hypertension is one of the systemic causes of epistaxis among our patients which is still prevalent in our settings, however slightly low as compared to the previous studies. Females have a higher occurrence of epistaxis compared to males and the most common age group involved are patients at the fifth and sixth decades. Likewise, in terms of severity, most of the time is mild to moderate. The health care providers managing these groups of patients should also evaluate the co-existence of the two disorders for the better outcome of treatment.