J Rhinol.  2023 Mar;30(1):23-30. 10.18787/jr.2023.00001.

Risk Factors for Rebleeding After Successful Rapid Rhino Packing in Epistaxis Patients

• Oh JT
• Bae MR

• KMID: 2540854
• DOI: http://doi.org/10.18787/jr.2023.00001

Abstract

Background and Objectives
Epistaxis is one of the most common emergencies in otolaryngology, and the recently developed Rapid Rhino nasal pack, a balloon-type nasal packing device, is widely used in emergency departments. Rebleeding after initial treatment increases patients’ discomfort and medical costs. The aim of this study was to investigate risk factors for rebleeding in patients treated with Rapid Rhino packing.
Methods
In this retrospective study, 93 patients with epistaxis treated with Rapid Rhino from January 2020 to November 2022 were divided into the well-controlled group (39 patients) and the rebleeding group (54 patients), and the baseline characteristics, management methods, and complications were compared between these groups. The rebleeding group was divided according to whether patients experienced a single episode of rebleeding (38 patients) or multiple rebleeding episodes (16 patients), and the differences between these two groups were compared.
Results
Oral anticoagulation therapy was associated with a higher risk of rebleeding after Rapid Rhino packing (odds ratio [OR]=8.41, p=0.047). A history of nasal surgery was associated with multiple rebleeding (OR=22.55, p=0.009). Age, sex, the management method, complications, and the site of bleeding were not found to be related to rebleeding.
Conclusion
Patients with rebleeding after Rapid Rhino nasal packing had a higher rate of concurrent oral anticoagulation therapy. A history of nasal surgery was strongly associated with multiple episodes of rebleeding. A detailed medical history can be important for assessing the risk of rebleeding in epistaxis patients treated with Rapid Rhino packing.

Keyword

Epistaxis; Anticoagulants; Risk factors

Figure

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  Fig. 1. A schematic diagram of the management flow of epistaxis patients and participant selection process in this study.

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  Fig. 2. Utilization of a Rapid Rhino nasal pack. A: Soak the device in sterile water for 30 seconds. B: Insert along the nasal floor. C: Inflate the balloon with air. D: Tape to the patient’s cheek. Remove after 24–72 hours.

Reference

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