Epistaxis risk factors

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Editor in Chief: C. Michael Gibson, M.S., M.D. [[1]], Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D. José Eduardo Riceto Loyola Junior, M.D.[1]


The most common risk factor of epistaxis is trauma. Other risk factors include coagulopathies, infections and vascular abnormalities. It can occur spontaneously. Childhood and senility are unchangeable risk factors.

Risk Factors

  • Hypertension may be associated with epistaxis. A study has shown that incidence rates for epistaxis were significantly higher in the hypertensive patients, and they required posterior nasal packing more often than the control group (1.9% vs. 0.4%).[4]


  1. Tunkel, David E.; Anne, Samantha; Payne, Spencer C.; Ishman, Stacey L.; Rosenfeld, Richard M.; Abramson, Peter J.; Alikhaani, Jacqueline D.; Benoit, Margo McKenna; Bercovitz, Rachel S.; Brown, Michael D.; Chernobilsky, Boris; Feldstein, David A.; Hackell, Jesse M.; Holbrook, Eric H.; Holdsworth, Sarah M.; Lin, Kenneth W.; Lind, Meredith Merz; Poetker, David M.; Riley, Charles A.; Schneider, John S.; Seidman, Michael D.; Vadlamudi, Venu; Valdez, Tulio A.; Nnacheta, Lorraine C.; Monjur, Taskin M. (2020). "Clinical Practice Guideline: Nosebleed (Epistaxis)". Otolaryngology–Head and Neck Surgery. 162 (1_suppl): S1–S38. doi:10.1177/0194599819890327. ISSN 0194-5998.
  2. Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
  3. Douglas, Richard; Wormald, Peter-John (2007). "Update on epistaxis". Current Opinion in Otolaryngology & Head and Neck Surgery. 15 (3): 180–183. doi:10.1097/MOO.0b013e32814b06ed. ISSN 1068-9508.
  4. Byun H, Chung JH, Lee SH, Ryu J, Kim C, Shin JH (2020). "Association of Hypertension With the Risk and Severity of Epistaxis". JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2020.2906. PMC 7489409 Check |pmc= value (help). PMID 32910190 Check |pmid= value (help).

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