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Factors associated with definitive observation unit care in patients with non-traumatic epistaxis: a retrospective observational study

  • Dong Ki Kim1,†
  • Chung Man Sung2,†
  • Jin Hyeok Park3
  • Sung Min Lee4,*,
  • Hyung Chae Yang2,*,

1Department of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of Korea

2Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, 61469 Gwangju, Republic of Korea

3Department of Biology, Temple University, Philadelphia, PA 19122, USA

4Department of Emergency Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, 58128 Hwasun, Republic of Korea

DOI: 10.22514/sv.2024.013 Vol.20,Issue 3,March 2024 pp.39-45

Submitted: 03 July 2023 Accepted: 03 August 2023

Published: 08 March 2024

*Corresponding Author(s): Sung Min Lee E-mail:
*Corresponding Author(s): Hyung Chae Yang E-mail:

† These authors contributed equally.


Epistaxis is one of the common causes of emergency department (ED) visits. However, most cases are not severe and undergo an unnecessary medical evaluation, especially in non-traumatic epistaxis. This study investigated how many patients require a definite observational unit (DOU) and what factors are associated with DOU among non-traumatic epistaxis patients. This retrospective observational study included 1197 non-traumatic epistaxis patients who visited the ED from January 2016 to December 2020. Multiple logistic regression analysis was performed to evaluate the association between risk factors and DOU care. In addition, the receiver operating characteristic (ROC) curve for predicting DOU care was analyzed to estimate the diagnostic ability of risk factors. A total number of 1122 patients with non-traumatic epistaxis were included in the final analysis. Among them, 41 (3.65%) patients needed DOU care. Male sex (odds ratio (OR) = 3.606, p = 0.003), hypertension (OR = 2.362, p = 0.020), inter-hospital transfer (OR = 2.358, p = 0.039), verbal mental status (OR = 29.436, p = 0.035), hemoglobin (Hb) level (OR = 0.724, p < 0.001), revisit after initial discharge for epistaxis (OR = 8.813, p < 0.001), and delayed ED arrival (≥180 min) (OR = 2.451, p = 0.030) were significant factors for DOU care. In addition, the area under the curve of the multiple logistic regression model for predicting DOU care was 0.870. Among the patients who visited ED due to non-traumatic epistaxis, only 3.65% of patients required DOU care. Male sex, mental status, Hb level, ED revisit after initial discharge, inter-hospital transfer and delayed ED arrival (>180 min) were associated with DOU care. These findings will help to triage epistaxis patients before they visit the ED.


Epistaxis; Emergency care; Risk factor; Hospitalization; Health resources

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Dong Ki Kim,Chung Man Sung,Jin Hyeok Park,Sung Min Lee,Hyung Chae Yang. Factors associated with definitive observation unit care in patients with non-traumatic epistaxis: a retrospective observational study. Signa Vitae. 2024. 20(3);39-45.


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