Comparison of different groups of anticoagulants in relation to the occurrence and severity of epistaxis

Introduction The main objective of this paper is to analyse anticoagulation therapy as a risk factor for the occurrence of epistaxis. The study compared the groups of classical with the new oral anticoagulants and aimed to determine whether there are differences in the severity of epistaxis.

Methods A retrospective analysis of all adult patients diagnosed with epistaxis who were hospitalised in the ENT clinic of the UKGM Giessen in the period 01.01.2017 – 31.12.2018 was performed. A total of 260 cases of epistaxis were documented during this period. In order to be able to quantify the severity of epistaxis, we used a severity score comprising the point sum of various parameters: Hb level, epistaxis therapy, duration of hospital treatment, epistaxis recurrence, blood transfusion.

Results Of the 260 patients 65% were treated with an antithrombotic drug. Of these, 39% were treated with ASA, 29% with Marcumar, 7% with combined therapy and 25% with new oral anticoagulants. The mean value of the severity score for the patient group without anticoagulation therapy was 5.75 and for the patient group with anticoagulation therapy was 6.40. In addition, the severity score was calculated for the patients under the so-called classical as well as under the new oral anticoagulation therapy. This was 6.20 for the first and 6.98 for the second group.

Conclusion No evidence was found that the severity of epistaxis differed between groups of patients with and without anticoagulation therapy and among the different groups of anticoagulants. Further studies, which are prospective and take into account outpatients, are necessary.

Publication History

Article published online:
12 May 2023