ABSTRACT
This was a prospective study and analysis of the clinical nature and severity of consultation, patient age and sex, place of consultation, grade of attending doctor and management strategy of in-patients referred for a specialist opinion to a Department of Otolaryngology. Internal requests for consultation were evaluated at the North Manchester General Hospital between October 1999 and August 2000 (n = 101). Patients referred to the Otolaryngology department were of a varied clinical nature with head and neck complaints being the largest group. Forty-six of the patients had minor complaints. Patients were found to be predominantly male and older than 50 years of age. The grade of attending doctor was predominantly a Specialist Registrar and the management strategy was most frequently conservative. Many of the requests for consultation were regarding minor problems that could be referred to a routine out-patient clinic. There is a need to improve the indication criteria for internal consultation, as well as the information provided in them.
Subject(s)
Hospital Departments , Otorhinolaryngologic Diseases , Referral and Consultation/standards , Adolescent , Adult , Aged , Aged, 80 and over , Ear Diseases/diagnosis , Female , Humans , Male , Medical Records/standards , Medical Staff, Hospital , Middle Aged , Nose Diseases/diagnosis , Otorhinolaryngologic Diseases/diagnosis , Otorhinolaryngologic Diseases/therapy , Prospective Studies , Severity of Illness IndexABSTRACT
The relationship between the upper and lower airways in chronic obstructive pulmonary disease (COPD) is unknown. We examined the prevalence of chronic nasal symptoms and the correlation with lower respiratory symptoms and parameters of severity of COPD such as exacerbation frequency and spirometry. 61 COPD patients from the East London COPD cohort were studied. [Mean (SD) age 70 (6.96) years, FEV1 0.98 (0.38) l, FVC 2.45 (0.72) l, FEV1%Pred 37.0 (12.3), and 47.6 (31.8) smoking pack years, 14 current smokers, 36 males]. COPD patients had a high prevalence of nasal symptoms (75%), more than half reporting nasal discharge (52.5%) and sneezing (45.9%). Associations were found between nasal score and daily sputum production (P = 0.005) and post-nasal drip and sputum production (P = 0.046) with a trend to increased nasal symptoms in frequent exacerbators compared to infrequent exacerbators. No significant relationship was found between nasal symptoms and FEV1 or any other lower respiratory airway symptom. Associations between nasal and respiratory symptoms were found suggesting that there is a relationship between the upper and lower airway in COPD.
