Endocrine Abstracts

JOINT354

Introduction: Epistaxis is a common condition encountered in otorhinolaryngology, generally benign, but it can occasionally present as a severe and life-threatening event. For patients with diabetes mellitus (DM), epistaxis may be a sign of underlying vascular complications. This study aims to evaluate the relationship between diabetes and the severity of epistaxis and its implications for management strategies.

Methods: A retrospective cross-sectional analytical study was conducted at the Department of Otolaryngology–Head and Neck Surgery of Farhat Hached University Hospital, encompassing patients consulting and/or admitted for epistaxis between January 2015 and December 2022.

Results: A total of 720 cases were analyzed. Of these, the majority (87.9%) were classified as benign and managed on an outpatient basis, while 12.1% of patients presented with severe epistaxis necessitating hospitalization. A significant prevalence of cardiovascular diseases was observed, including hypertension (32.9%), diabetes (12.8%) and dyslipidemia (6.9%). Other noteworthy medical conditions included chronic kidney disease (n =19; 2,6%) and haematological pathologies (n =11; 1,5%). Despite the prevalence of diabetes (12.8%), no statistically significant correlation was found between diabetes and the severity of epistaxis. Contrary to previous studies suggesting a direct association between DM and severe epistaxis, our findings suggest that diabetes may act as a predisposing factor by inducing vascular changes such as endothelial dysfunction and impaired hemostasis. Additionally, diabetes mellitus may contribute to atherosclerotic changes in the nasal vessels, increasing their fragility and susceptibility to bleeding. The coexistence of cardiovascular conditions, such as hypertension and dyslipidemia, which are frequently associated with diabetes, may further exacerbate the risk of epistaxis in this population.

Conclusion: Diabetes mellitus may increase the risk of epistaxis through its effects on vascular integrity, though its role in determining the severity of the condition remains uncertain. Further large-scale, prospective studies are needed to elucidate the underlying pathophysiological mechanisms and refine management strategies for diabetic patients presenting with epistaxis.

Keywords: Epistaxis – Bleeding – Diabetes Mellitus - Severity criteria - Risk Factors – Management.