Prevalence and characteristics of S-point bleeding compared to non S-point bleeding in severe epistaxis

Abstract Introduction Stamm's S-point is gaining importance as a bleeding focus in severe epistaxis. However, prevalence and features of S-point bleeding compared to non S-point bleeding have not been studied. Objective To investigate the characteristics of patients with S-point bleeding among those with severe epistaxis and to compare the factors involved in the treatment of epistaxis. Methods We retrospectively analyzed medical records of 268 patients admitted to the otorhinolaryngology department of Konkuk University Hospital and Chung-Ang University Hospital with epistaxis of which the bleeding focus clarified. Patients with anterior nasal bleeding (n = 129) were excluded. The study was conducted at the department of otorhinolaryngology from January 2008 to August 2019. Collected data included patients' demographic information, bleeding focus, body mass index underlying medical and sinonasal diseases, laboratory test results (initial hemoglobin, platelet count, and triglyceride level), use of anticoagulants, direction of epistaxis, initial and final treatments, and need for blood transfusion. Results The prevalence of S-point bleeding was 28.8% of non-anterior bleeding cases. Mean body mass index score was lower in the S-point group (23.41 ± 3.71) compared to the non S-point group (24.93 ± 3.97) (p = 0.039). Underweight patients tended to show a greater incidence of S-point bleeding (15.0%) than non S-point bleeding (2.0%) (p = 0.010). Incidence of anemia was higher in the S-point group (67.5%) than in the non S-point group (36.4%). Anemia (Odds ratio [OR]: 3.635; 95% confidence interval [CI]: 1.669-7.914, p = 0.001) and underweight (body mass index

### 摘要
引言：S点（Stamm's S-point）作为严重鼻出血（severe epistaxis）的出血靶点，其临床重要性日益凸显，但目前尚无研究对比S点出血与非S点出血的患病率及临床特征。
研究目的：本研究旨在探讨严重鼻出血患者中S点出血患者的临床特征，并对比影响鼻出血治疗的相关因素。
方法：本研究回顾性分析了2008年1月至2019年8月期间，建国大学医院（Konkuk University Hospital）与中央大学医院（Chung-Ang University Hospital）耳鼻咽喉科收治的268例明确出血靶点的鼻出血患者的病历资料，排除前鼻腔出血患者（n=129）。收集的资料涵盖患者人口统计学信息、出血靶点、体重指数（body mass index, BMI）、基础疾病与鼻鼻窦疾病、实验室检查结果（初始血红蛋白水平、血小板计数及甘油三酯水平）、抗凝药物使用情况、鼻出血侧别、初始及最终治疗方案，以及输血需求。
结果：S点出血在非前鼻腔出血病例中的患病率为28.8%。S点组患者的平均体重指数（23.41±3.71）低于非S点组（24.93±3.97，p=0.039）。体重偏低患者的S点出血发生率（15.0%）高于非S点出血患者（2.0%，p=0.010）。S点组患者的贫血发生率（67.5%）高于非S点组（36.4%）。贫血（比值比（odds ratio, OR）=3.635；95%置信区间（confidence interval, CI）=1.669~7.914，p=0.001）与体重偏低（体重指数