Analysis of mean platelet volume and red blood cell distribution width in recurrent epistaxis

Ali Ekber Karabulut; Yunsur Çevik; Emine Emektar; Şeref Kerem Çorbacioğlu; Seda Dağar; Oğuz Yardim

doi:10.1016/j.tjem.2018.02.001

Ali Ekber Karabulut¹, Yunsur Çevik², Emine Emektar², Şeref Kerem Çorbacioğlu², Seda Dağar², Oğuz Yardim³

¹Department of Emergency Medicine, Van Training and Research Hospital, Van, Turkey
²Department of Emergency Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
³Department of Emergency Medicine, Bayburt State Hospital, Bayburt, Turkey

Keywords: Emergency department; Mean platelet volume; Recurrent epistaxis; Red blood cell distribution width

Abstract

Objectives: Recurrent epistaxis is one of the most common causes of emergency department visits. Although several localized and systemic conditions has been described, the exact cause is unknown in the majority of cases. In our study, we aimed to determine the effect of mean platelet volume (MPV) and red blood cell distribution width (RDW) levels on recurrent epistaxis.

Method: One hundred and thirty six patients with recurrent epistaxis and 170 healthy cases as control group were included in the study. Demographic data, vital signs and the results of complete blood counts were recorded. The patients who had clinical conditions that might affect the levels of MPV or RDW, were excluded. MPV and RDW levels were compared between the two groups.

Results: The median level of MPV was 7.6 fL (IQR25–75%: 7.1–8.4) in the study group and 8.2 fL (IQR25–75%: 7.8–8.9) in the control group (p < 0.001). The median levels of RDW were found in the patient and control groups in order %15.4 (IQR25–75%: 14.5–15.4) and %14.3 (IQR25–75%: 13.4–15.4) (p < 0.001). Systolic blood pressure, leukocyte count, age, sex, RDW and MPV levels that were variables with p levels<0.2, were included in the multivariate analyses. It was determined that high RDW levels increased epistaxis (p < 0.001; OR:1.89 [95% CI:1.53–2.33]) and high MPV levels decreased epistaxis (p < 0.001; OR:0.54 [95% CI:0.39–0.72]).

Conclusion: Low MPV and high RDW levels caused an increased bleeding tendency in patients with recurrent epistaxis. Although exact mechanism is not known, referring those patients for the assessment of etiologic causes would be proper.