Abstract
Background Epistaxis is one of the most common emergencies encountered across all age groups. However, its etiological patterns and management outcomes exhibit significant regional variation. This retrospective study aims to assess the epidemiology, etiology, clinical presentation, treatment modalities, and outcomes of epistaxis in a tertiary referral hospital. Methods A retrospective, observational study was conducted at our center involving 384 patients who presented with epistaxis between January 2020 and June 2025. Patient records were reviewed for demographics, etiology, treatment modalities, and outcomes. Descriptive statistics were used to summarize the data. Results Anterior epistaxis constituted 68.7% (264/384) of cases. Trauma was the most common etiology (59.9%, 230/384), followed by hypertension (20.1%, 77/384) and dengue fever (5.9%, 23/384). The most common intervention was anterior nasal packing (59.9%, 230/384), followed by conservative management (26.6%, 102/384). Cauterization was used in 5.9% (23/384) of cases, and combined anterior and posterior packing in 6.3% (24/384). Surgical ligation was rarely required (1.3%, 5/384). Initial bleeding control was achieved in 93.7% (360/384) of patients, and 6.3% (24/384) required repeat intervention. Documented complications included re-bleeding (5.9%), sinusitis (3.9%), and septal ulceration (2.1%). Conclusion Trauma and hypertension were the primary etiologies of epistaxis, with anterior nasal packing constituting the fundamental approach to management. These results emphasize the significance of targeted prevention, early etiological identification, and structured management protocols to enhance outcomes.