The goal of this study was to evaluate independent risk factors for long-term
epistaxis recurrences and their severity. Individual retrospective cohort study-2b level of evidence. The medical information of 603 emergency
epistaxis patients was acquired during a former study. This cohort has been contacted 6 years later by conventional mail and asked to answer a specific paper questionnaire. The following parameters were evaluated: recurrent
epistaxis episodes, need for a surgical intervention to stop the recurrent
bleeding, patient's history for
hypertension and diabetes, intake of hemostasis impairing medication now and in the past. One hundred and six (106) patients were included in the study (35.8 % response rate). The mean observation period was 76.58 months. Almost half of the patients (41.5 % = 44/106) reported at least one recurrent
epistaxis episode. Patients with exposure to VKA (
vitamin K antagonists) showed significantly more frequently a recurrent
epistaxis episode. The binary logistic regression confirmed the intake of VKA as an independent and significant risk factor with an odds ratio of 11.6. Every single patient who had to undergo a surgical intervention to stop a recurrent
bleeding stated ASA (
Acetylsalicylic Acid) intake. We provide evidence that the intake of a
vitamin K antagonist is an independent long-term risk factor for recurrent
epistaxis episodes. The intake of ASA is a risk factor for the severity of recurrent
epistaxis with the increased need for a surgical intervention not only in a short- but also in a long-term perspective.
LEVEL OF EVIDENCE: This prognostic investigation, designed as a combined prospective and retrospective cohort study, reaches level 2b level of evidence as it includes retrospective aspects.