Evaluation of Hematologic Markers in Hypertensive and Non-hypertensive Epistaxis Patients

Yeşim Yüksel 1, Rezarta Taga Senirli 1, Nuray Ensari 1, Cihan Bedel 2 * , Fatih Selvi 2, Ökkeş Zortuk 3, Mustafa Korkut 2
More Detail
1 Department of Otolaryngology Head and Neck Surgery, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
2 Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
3 Department of Emergency Medicine, Hatay Defne State Hospital, Hatay, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 22, Issue 3, pp. 84-87. https://doi.org/10.23950/jcmk/16525
OPEN ACCESS 286 Views 138 Downloads
Download Full Text (PDF)
Author Contributions: Conceptualization, F. S. and O. Z.; methodology, study design, Y. Y. and C. B.; validation – not applicable; formal analysis, Y. Y.; investigation, Y. C.; resources – not applicable; data curation, Y. Y., C. B., Y. K.; writing – original draft preparation, Y. Y.; writing – review and editing, Y. Y.; visualization, Y. Y.; supervision, F. S. and O. Z.; project administration – not applicable; funding acquisition – not applicable. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The corresponding author can provide the data supporting the study's conclusions upon request. Due to ethical and privacy constraints, the data are not publicly accessible.

ABSTRACT

Objective: The objective of the study is to investigate the development of epistaxis and its relationship with hypertension, as well as inflammatory parameters such as the neutrophil-lymphocyte ratio (NLR), the pan-immune inflammation value (PIV), the systemic inflammatory response index (SIRI), the systemic immune-inflammation index (SII) and the aggregate index of systemic inflammation (AISI).
Methods: Our study is a retrospective analysis of patients diagnosed with and treated for epistaxis from January 2021 to January 2023. Patient demographic information and NLR, PIV, SIRI, SII and AISI were calculated. Patients were divided into two groups based on their systolic blood pressure measurements: The study then compared the two groups.
Results: A total of 743 participants who met the inclusion criteria were enrolled in the study, with 545 (73.3%) cases of non-hypertensive epistaxis and 198 (26.7%) cases of hypertensive epistaxis.  The neutrophil-to-lymphocyte ratio (NLR) was found to be significantly higher in hypertensive epistaxis (3.6 vs. 1.6; p<0.001) when evaluating the combined blood parameters. Furthermore, PIV values were notably elevated in the hypertensive group (813.53 vs 252.71; p<0.001). Consequently, SII, SIRI, and AISI values were found to be significantly higher in hypertensive epistaxis compared to non-hypertensive epistaxis.
Conclusion: NLR, PIV, SIRI, SII, and AISI in predicting bleeding in epistaxis patients presenting at the emergency department.
Keywords: Epistaxis, hypertension, inflamation

CITATION

Yüksel Y, Senirli RT, Ensari N, Bedel C, Selvi F, Zortuk Ö, et al. Evaluation of Hematologic Markers in Hypertensive and Non-hypertensive Epistaxis Patients. J CLIN MED KAZ. 2025;22(3):84-7. https://doi.org/10.23950/jcmk/16525

REFERENCES

  • Ahn EJ, Min HJ. Age-specific associations between environmental factors and epistaxis. Front Public Health. 2022; 19; 10: 966461. https://doi.org/10.3389/fpubh.2022.966461.
  • Caltekin I, Demir B, Atik D, Albayrak L, Gokcen E, Savrun A, Burak Kaya H. Evaluation of red blood cell distribution width and mean platelet volume levels in hypertensive and non-hypertensive epistaxis patients. Ann Med Res. 2021; 27(3): 0938–0942. https://doi.org/10.5455/annalsmedres.2019.11.689.
  • Küçükcan NE, Kanmaz MA. Can we determine recurrent epistaxis by hemogram parameters in children? Int J Pediatr Otorhinolaryngol. 2021; 146: 110747. https://doi.org/10.1016/j.ijporl.2021.110747.
  • Send T, Bertlich M, Eichhorn KW, Ganschow R, Schafigh D, Horlbeck F, Bootz F, Jakob M. Etiology, Management, and Outcome of Pediatric Epistaxis. Pediatr Emerg Care. 2021; 37(9): 466–470. https://doi.org/10.1097/PEC.0000000000001698.
  • Korkut M, Bedel C, Karancı Y, Duyan M. Can We Estimate the Recurrence of Epistaxis with Simple Blood Tests? J Clin Trials Exp Investig. 2020; 11(2): 1–6. https://doi.org/10.5799/jcei/7839.
  • Kim K, Kwak IY, Min H. Particulate Matter 10 (PM10) Is Associated with Epistaxis in Children and Adults. Int J Environ Res Public Health. 2021; 18(9): 4809. https://doi.org/10.3390/ijerph18094809.
  • Zinellu A, Collu C, Nasser M, Paliogiannis P, Mellino S, Zinellu E, Traclet J, Ahmad K, Mangoni AA, Carru C, Pirina P, Fois AG, Cottin V. The Aggregate Index of Systemic Inflammation (AISI): A Novel Prognostic Biomarker in Idiopathic Pulmonary Fibrosis. J Clin Med. 2021; 10(18): 4134. https://doi.org/10.3390/jcm10184134.
  • Zhou Q, Su S, You W, Wang T, Ren T, Zhu L. Systemic Inflammation Response Index as a Prognostic Marker in Cancer Patients: A Systematic Review and Meta-Analysis of 38 Cohorts. Dose Response. 2021; 19(4): 15593258211064744. https://doi.org/10.1177/15593258211064744.
  • Ameya G, Biresaw G, Mohammed H, Chebud A, Meskele M, Hussein M, Endris M. Epistaxis and Its Associated Factors Among Precollege Students in Southern Ethiopia. J Blood Med. 2021; 12: 1–8. https://doi.org/10.2147/JBM.S285403.
  • Ekber Karabulut A, Çevik Y, Emektar E, Kerem Çorbacioğlu Ş, Dağar S, Yardim O. Analysis of mean platelet volume and red blood cell distribution width in recurrent epistaxis. Turk J Emerg Med. 2018; 18(2): 67–70. https://doi.org/10.1016/j.tjem.2018.02.001.
  • Montague ML, Whymark A, Howatson A, Kubba H. The pathology of visible blood vessels on the nasal septum in children with epistaxis. Int J Pediatr Otorhinolaryngol. 2011; 75(8): 1032–1034. https://doi.org/10.1016/j.ijporl.2011.05.011.
  • Aksakal C, Şahin M. Evaluation of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in recurrent epistaxis in childhood: case controlled study. Pan Afr Med J. 2019; 32: 154. https://doi.org/10.11604/pamj.2019.32.154.18372.
  • Bhutta H, Agha R, Wong J, Tang TY, Wilson YG, Walsh SR. Neutrophil-lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. Vasc Endovascular Surg. 2011; 45(3): 227–231 https://doi.org/10.1177/1538574410396590
  • Balta S, Demırkol S, Kucuk U. The platelet lymphocyte ratio may be useful inflammatory indicator in clinical practice. Hemodial Int. 2013; 17(4): 668–669. https://doi.org/10.1111/hdi.12058.
  • Gu L, Li H, Gao Y, Ma X, Chen L, Li X, Zhang Y, Fan Y, Zhang X. The association of platelet count with clinicopathological significance and prognosis in renal cell carcinoma: a systematic review and meta-analysis. PLoS One. 2015; 10(5): e0125538. https://doi.org/10.1371/journal.pone.0125538.
  • Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010; 6(1): 149–163. https://doi.org/10.2217/fon.09.136.
  • Lolli C, Basso U, Derosa L, Scarpi E, Sava T, Santoni M, Crabb SJ, Massari F, Aieta M, Conteduca V, Maruzzo M, La Russa F, Wheater M, Berardi R, Galli L, De Giorgi U. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget. 2016; 7(34): 54564–54571. https://doi.org/10.18632/oncotarget.10515.
  • Topkan E, Mertsoylu H, Kucuk A, Besen AA, Sezer A, Sezen D, Bolukbasi Y, Selek U, Pehlivan B. Low Systemic Inflammation Response Index Predicts Good Prognosis in Locally Advanced Pancreatic Carcinoma Patients Treated with Concurrent Chemoradiotherapy. Gastroenterol Res Pract. 2020; 2020: 5701949 https://doi.org/10.1155/2020/5701949.
  • Sun L, Hu W, Liu M, Chen Y, Jin B, Xu H, Du S, Xu Y, Zhao H, Lu X, Sang X, Zhong S, Yang H, Mao Y. High Systemic Inflammation Response Index (SIRI) Indicates Poor Outcome in Gallbladder Cancer Patients with Surgical Resection: A Single Institution Experience in China. Cancer Res Treat. 2020; 52(4): 1199–1210. https://doi.org/10.4143/crt.2020.303.
  • Lin J, Chen L, Chen Q, Zhuang Z, Bao X, Qian J, Hong Y, Yan L, Lin L, Shi B, Qiu Y, Pan L, Wei L, Zheng X, Wang J, Liu F, He B, Chen F. Prognostic value of preoperative systemic inflammation response index in patients with oral squamous cell carcinoma: Propensity score-based analysis. Head Neck. 2020; 42(11): 3263–3274. https://doi.org/10.1002/hed.26375.
  • Chao B, Ju X, Zhang L, Xu X, Zhao Y. A Novel Prognostic Marker Systemic Inflammation Response Index (SIRI) for Operable Cervical Cancer Patients. Front Oncol. 2020; 10: 766. https://doi.org/10.3389/fonc.2020.00766.
  • Geng Y, Zhu D, Wu C, Wu J, Wang Q, Li R, Jiang J, Wu C. A novel systemic inflammation response index (SIRI) for predicting postoperative survival of patients with esophageal squamous cell carcinoma. Int Immunopharmacol. 2018; 65: 503–510. https://doi.org/10.1016/j.intimp.2018.10.002.
  • Qi Q, Zhuang L, Shen Y, Geng Y, Yu S, Chen H, Liu L, Meng Z, Wang P, Chen Z. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016; 122(14): 2158–2167. https://doi.org/10.1002/cncr.30057.
  • Yildiz G. Selvi F. Bedel C. Zortuk O, Korkut Mustafa, Mutlucan UO. Systemic Inflammation Response Index and Systemic Immune Inflammation Index for Predicting Acute Cholecystitis. Indian Journal of Medical Specialities. 2023; 14(2): 88–92. https://doi.org/10.4103/injms.injms_5_23.
  • Yıldız G, Selvi F, Bedel C, Zortuk Ö, Yavuz Y. Systemic inflammatory response index (SIRI) and Systemic immune-inflammation index (SII) to show Thrombus Localization in Patients with Acute Pulmonary Embolism. Osmangazi Med J. 2023; 45(5): 665–671. https://doi.org/10.20515/otd.1276480.