Author(s)
Flora Yan, MD
Hetvi Patel, BA
Glenn Isaacson, MD
Affiliation(s)
Temple University Lewis Katz School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to appreciate variations in the frequency of epistaxis in children of different ages.
Objectives: Epistaxis seems to be rare in very young children and more common in the late first decade. We sought to confirm or refute this clinical impression using a representative national outpatient database.
Study Design: A cross-sectional analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from the years 2007-2011 was performed.
Methods: The NHAMCS is a CDC curated national sample of data from visits to non-federally employed office based physicians and health centers. We queried the NHAMCS to determine the cumulative incidence of epistaxis in children of different age groups. Cases of epistaxis was defined by ICD-9 code 784.7, given data was obtained prior to initiation of ICD-10. Comparison of rates was performed using the chi squared test. A p value less than 0.05 was considered statistically significant.
Results: In total, 55,435,691 children (27,816,237 [50.2%] male, 55,435,691 [77.2] white) were included. The overall cumulative incidence rate was 2.4/1000 children. Children in the 5-8 year range had the highest cumulative incidence of epistaxis (4.8/1000), followed by those in the 0-4 (2.3/1000), 9-12 (2.1/1000), and 13-17 (0.8/1000) year ranges (p less than 0.001).
Conclusions: Pediatric epistaxis is common in the office setting (2.4 per 1000 children) -- well about estimates in the emergency room setting (1.7 per 1000 people). Children between the ages of 5-8 years have the highest cumulative incidence of epistaxis. We discuss possible causes of more frequent epistaxis in the population.