Is coagulation profile routinely indicated in Epistaxis?

Abstract

Background: Epistaxis is the most common ENT emergency worldwide. It is also common ENT problem in Nepal. Most cases of epistaxis don’t have an easily identifiable cause. Both local and systemic processes can play a role in it. Treatment of severe epistaxis can encompass different modalities. Objective: To observe the significance of coagulation studies to find out a cause for epistaxis. Materials and Methods: A retrospective chart review of coagulation studies of 124 cases(male=85, female=39) of epistaxis patients admitted in ENT-Head and Neck Surgery ward of T.U.Teaching Hospital from January 2005 to June 2006 was performed to find out the coagulation disorder in such patients. Results: There were 124 patients with epistaxis admitted during the study period of 1 1/2 year duration with M: F ratio 2.2:1. Prothrombin Time ranged between 11-16 seconds, Bleeding Time between 2-8 minutes, Activated Partial Thrombin Time between 25-35 seconds, and International Normalized Ratio between 0.8-1.2. All those values being normal, we did not further investigate for factor assays.None of the patients with epistaxis had coagulation profile derangement. Conclusion: From our study it seems that routine coagulation profile is not necessary in patients with epistaxis. The indications for coagulation profile testing in patients with epistaxis should be identified by a more scientific larger study. At present, the tests should be done when there is high suspicion of such disorders. Key words: Coagulation disorder, Epistaxis. The full text of this paper is available at Journal of Institute of Medicine website