{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:52:14Z","timestamp":1790092334273,"version":"4.0.1"},"reference-count":32,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    Little is known about the prevalence of epistaxis in children. Existing reports focus on hospitalized children or those presenting to an emergency department. To better understand pediatric epistaxis in clinical practice, we sought out a searchable, representative outpatient database and examined the incidence of epistaxis in children of different ages.\n                    <jats:bold>Methods:<\/jats:bold>\n                    A cross-sectional analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from the years 2007 to 2011 was performed. The NHAMCS is a Centers for Disease Control and Prevention-curated national sample of data from visits to non-federally employed office-based physicians and health centers. We queried the NHAMCS to determine the cumulative incidence of epistaxis in children of different age groups. The International Classification of Diseases Ninth Revision code 784.7 was chosen to identify epistaxis. Comparisons of rates were performed using the chi-squared test. A\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    -value of &lt;.05 was considered statistically significant.\n                    <jats:bold>Results<\/jats:bold>\n                    : In total, 55,435,691 children [27,816,237 (50.2%) males, 55,435,691 (77.2%) white] were included. The overall cumulative incidence rate of epistaxis was 2.4\/1000 children. Children in the 3- to 5-year range had the highest cumulative incidence of epistaxis (5.0\/1000), followed by those in the 6 to 8 (3.0\/1000), 9 to 11 (2.0\/1000), 0 to 2 (1.9\/1000), 12 to 14 (1.6\/1000), and 15 to 17 (0.5\/1000) year ranges (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .001).\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Pediatric epistaxis is common in the office setting (2.4 per 1000 children)\u2014and well above emergency department estimates (1.7 per 1000 people). Children between the ages of 3 to 5 years have the highest cumulative incidence. Epistaxis is sufficiently unusual in infants and the late teens that alternative causes for nasal bleeding should be included in the differential diagnosis.\n                  <\/jats:p>","DOI":"10.1177\/01455613231207291","type":"journal-article","created":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T02:20:26Z","timestamp":1697854826000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Age Distribution of Epistaxis in Outpatient Pediatric Patients"],"prefix":"10.1177","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0724-4329","authenticated-orcid":false,"given":"Flora","family":"Yan","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology \u2013 Head &amp; Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetvi P.","family":"Patel","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology \u2013 Head &amp; Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-1796","authenticated-orcid":false,"given":"Glenn","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology \u2013 Head &amp; Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA"},{"name":"Department of Pediatrics, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2015-205528"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2004.04.015"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000195369.01289.9B"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.05.013"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.06.009"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.10.026"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819889955"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818785898"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27015"},{"key":"e_1_3_3_11_2","unstructured":"Centers for Disease Control and Prevention. Ambulatory health care data (2007-2011). Accessed November 17 2022. https:\/\/www.cdc.gov\/nchs\/ahcd\/index.htm"},{"key":"e_1_3_3_12_2","unstructured":"NHAMCS Dataset (2007-2011). Accessed May 6 2023. https:\/\/ftp.cdc.gov\/pub\/Health_Statistics\/NCHS\/dataset_documentation\/nhamcs\/spss\/"},{"key":"e_1_3_3_13_2","unstructured":"Codify by AAPC. Epistaxis (784.7) 1977. Accessed November 17 2022. https:\/\/www.aapc.com\/codes\/icd9-codes\/784.7#:~:text=ICD%2D9%20code%20784.7%20for SYMPTOMS%20(780%2D789)"},{"key":"e_1_3_3_14_2","unstructured":"US Census Bureau. Geographic levels 2021. Accessed August 29 2023. https:\/\/www.census.gov\/programs-surveys\/eco-nomic-census\/guidance-geographies\/levels.html#-par_textimage_34"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.12.014"},{"key":"e_1_3_3_16_2","first-page":"83","article-title":"Epistaxis in childhood","volume":"17","author":"Petruson B","year":"1979","unstructured":"Petruson B. Epistaxis in childhood. Rhinology. 1979;17:83-90.","journal-title":"Rhinology"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1790-9"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.09.043"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000134"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/pxy197"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.160.6.596"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1989.01860250065028"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-022-01452-7"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(02)00079-4"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30640"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30961"},{"key":"e_1_3_3_27_2","article-title":"Epistaxis in a pediatric outpatient clinic: could it be an alarming sign?","volume":"26","author":"ElAlfy MS","year":"2022","unstructured":"ElAlfy MS, Tantawy AAG, Eldin B, Mekawy MA, Mohammad YAE, Ebeid FSE. Epistaxis in a pediatric outpatient clinic: could it be an alarming sign? Int Arch Otorhinolaryngol. 2022;26:e183-e190.","journal-title":"Int Arch Otorhinolaryngol"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/014556131809700901"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.07.053"},{"key":"e_1_3_3_30_2","first-page":"199","article-title":"Does the weather really affect epistaxis?","volume":"10","author":"Kemal O","year":"2014","unstructured":"Kemal O, Sen E. Does the weather really affect epistaxis? B-ENT. 2014;10:199-202.","journal-title":"B-ENT"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816667295"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2015.29.4239"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1990.tb00432.x"}],"container-title":["Ear, Nose &amp; Throat Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613231207291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01455613231207291","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613231207291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:34:20Z","timestamp":1777401260000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01455613231207291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,20]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/01455613231207291"],"URL":"https:\/\/doi.org\/10.1177\/01455613231207291","relation":{},"ISSN":["0145-5613","1942-7522"],"issn-type":[{"value":"0145-5613","type":"print"},{"value":"1942-7522","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,20]]}}}