In this Turkish study, the authors attempted to determine if there was an association between ABO blood type and epistaxis. They looked at 359 epistaxis admissions at the same hospital over a three-year period. Only patients with idiopathic epistaxis were included (those with recognised risk factors for epistaxis such as anticoagulant use, liver disease and bleeding disorders were excluded). A control group was created using the national blood bank registry. Interestingly, the authors found that blood type O occurred significantly more frequently (p<0.001) in the epistaxis group than the control group, and blood type B occurred significantly less frequently (p<0.05) in the epistaxis group than the control group. The authors hypothesise that this could be due to the fact that there are decreased circulating levels of Factor VIII and von Willebrand factor in patients with blood type O, which disrupts the functioning of the intrinsic coagulation pathway and increases the risk of bleeding. This is a novel study, but further studies, particularly looking at risk factors for patients with severe intractable epistaxis, would be useful for risk stratification.

Is blood type really a risk factor for epistaxis?
Ozbay I, Binnetoglu A, Kucur C, et al.
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Sunil Sharma

Alder Hey Children's Hospital, UK.

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