季节与鼻出血的关系及鼻出血住院的危险因素

目的 通过大样本量鼻出血患者就诊的预检信息,分析鼻出血患者在每个季节的分布特点,以及评估需要住院手术处理鼻出血患者的危险因素。方法 从2008年2月~2015年11月来我院急诊就诊的188715例患者组成的急诊预检数据库中抽取2009年1月1日~2014年12月30日的数据。横断面研究。通过Pearson Chi-Square检验,分析季节变换对于不同年龄组鼻出血患者就诊量的影响。建立多元logistic回归模型,探索季节变换、性别、年龄、白天与夜晚就诊、年份是否为鼻出血住院手术治疗的危险因素。结果 共获得14420例鼻出血患者资料,平均年龄为(47.75±24.01)岁,其中男性占65.9%,41~69岁是鼻出血就诊量最多的年龄段。年龄≤40岁的鼻出血患者,就诊量最高的季节为春季;年龄>40岁的鼻出血患者,就诊量最高的季节为冬季(P<0.001)。冬季是鼻出血住院的高峰季节(P<0.001)。鼻出血收住入院的高风险因素为冬季(OR=1.386, 95% CI:1.200~1.601)和秋季(OR=1.226, 95% CI:1.051~1.431);夜间就诊比白天多(OR=1.331, 95% CI:1.193~1.486);男性比女性多(OR=1.968, 95% CI:1.730~2.238);年龄>40岁者比年龄≤40岁者多(OR=2.206, 95% CI:1.932~2.518)。结论 不同年龄段鼻出血的就诊量随着季节的变化而不同,提示鼻出血在各个季节及各个年龄段的发病原因可能不同。秋冬季、夜间就诊、年龄大的男性鼻出血患者病情相对严重,预检时应予以重视。

Relationship between seasons and epistaxis and the risk factors of epistaxis hospitalization

Objective To evaluate the relationship between seasonal variation and epistaxis in different age groups and to explore the risk factors of epistaxis admission.Methods Database composed of 188 715 registration patients in the emergency room between February 2008 and November 2015 were used. Pearson Chi-Square was used to analyze the relationship between seasonal variation and epistaxis presentation in different age groups. Moreover, a multivariate logistic regression model was set up to explore if season variation, gender, age group, registration time (daytime vs. overnight), years were associated with a higher risk of epistaxis admission.Results A total of 14 420 epistaxis patients were extracted. The mean age was 47.75±24.01 years old. Male covered 65.9%, and 41 to 69 years old was the peak age group. The numbers of epistaxis presentation peaked in spring at the age ≤ 40 years old and peaked in winter at the age over 40(P<0.001). The number of patients needing hospitalization peaked in winter(P<0.001). Higher risk of epistaxis patients’ admission in winter (OR=1.386, 95% CI:1.200~1.601) and autumn (OR=1.226, 95% CI:1.051~1.431), and risk registration time was overnight(OR=1.331, 95% CI:1.193~1.486). In addition, the other significant predictors of inpatient admission included: male gender (OR=1.968, 95% CI:1.730~2.238), age group > 40 (OR=2.206, 95% CI:1.932~2.518).Conclusions The numbers of epistaxis presentation differed with seasonal variation in different age groups, which might result from the varied etiologies of epistaxis. Older male epistaxis visitor’s registration overnight in the cold season in the emergency room might be more severe.