A seasonal variation to epistaxis in East Kent, UK

Epistaxis remains a common ENT emergency. Current evidence varies on whether a seasonal variation exists with the incidence of epistaxis. This review of epistaxis admissions in East Kent aimed to ascertain if indeed any relationship exists between epistaxis and any particular seasons or temperature. Methods: This was a retrospective review of all epistaxis admissions in the East Kent Hospitals NHS Trust (covering Ashford, Canterbury, Margate and surrounding Thanet) over a 5 year period: 2005 – 2009 inclusive. A total of 1,102 patients with epistaxis severe enough to require hospital admission were included in the study. The number of admissions were divided into the seasons: Winter (December – February), Spring (March – May), Summer (June – August) and Autumn (September – November). Epistaxis frequencies per year were also correlated with data on minimum and average monthly temperatures for the region supplied by the Meteorological Office UK. Results: Epistaxis admissions were highest in winter and lowest in summer. Winter 320 (29.04%), Spring 311 (28.22%), Summer 217 (19.69%) & Autumn 254 (23.05%). The parametric one way ANOVA and non-parametric Kruskal-Wallis tests demonstrated a statistically significant correlation between the seasons and epistaxis admissions; p<.05. Epistaxis admissions also correlated with mean monthly temperatures with an increase in admissions noted in cold temperatures (<10 degrees Celsius) p<.05. Conclusion: This study shows an increase in epistaxis admissions in winter months and correlation with monthly temperatures. This finding is corroborated by similar studies in the UK and Europe. A possible explanation is the effect of indoor heating during winter on increasing nasal mucosal dryness. Further studies are required to confirm this seasonal variation as this can inform workforce planning for epistaxis management.