Admission avoidance in tonsillitis and peritonsillar abscess: A prospective national audit during the initial peak of the COVID-19 pandemic.
Clin Otolaryngol
; 46(2): 363-372, 2021 03.
Article
in English
| MEDLINE | ID: covidwho-955613
ABSTRACT
OBJECTIVES:
To report changes in practice brought about by COVID-19 and the implementation of new guidelines for the management of tonsillitis and peritonsillar abscess (PTA), and to explore factors relating to unscheduled re-presentations for patients discharged from the emergency department (ED).DESIGN:
Prospective multicentre national audit over 12 weeks from 6 April 2020.SETTING:
UK secondary care ENT departments.PARTICIPANTS:
Adult patients with acute tonsillitis or PTA. MAIN OUTCOMEMEASURES:
Re-presentation within 10 days for patients discharged from the ED.RESULTS:
83 centres submitted 765 tonsillitis and 416 PTA cases. 54.4% (n = 410) of tonsillitis and 45.3% (187/413) of PTAs were discharged from ED. 9.6% (39/408) of tonsillitis and 10.3% (19/184) of PTA discharges re-presented within 10 days, compared to 9.7% (33/341) and 10.6% (24/224) for those admitted from ED. The subsequent admission rate of those initially discharged from ED was 4.7% for tonsillitis and 3.3% for PTAs. IV steroids and antibiotics increased the percentage of patients able to swallow from 35.8% to 72.5% for tonsillitis (n = 270/754 and 441/608) and from 22.3% to 71.0% for PTA (n = 92/413 and 265/373). 77.2% of PTAs underwent drainage (n = 319/413), with no significant difference in re-presentations in those drained vs not-drained (10.6% vs 9.5%, n = 15/142 vs 4/42, P = .846). Univariable logistic regression showed no significant predictors of re-presentation within 10 days.CONCLUSIONS:
Management of tonsillitis and PTA changed during the initial peak of the pandemic, shifting towards outpatient care. Some patients who may previously have been admitted to hospital may be safely discharged from the ED.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Patient Admission
/
Tonsillitis
/
Disease Management
/
Clinical Audit
/
Pandemics
/
Ambulatory Care
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
/
Young adult
Country/Region as subject:
Europa
Language:
English
Journal:
Clin Otolaryngol
Journal subject:
Otolaryngology
Year:
2021
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS