[Epidemiology and clinical findings in 20,563 patients attending the Lariboisière Hospital ENT Adult Emergency Clinic].

OBJECTIVES

Study the epidemiological and clinical features of patients attending the Lariboisière Hospital (Paris) ENT adult emergency clinic (La Grande Garde) over the first 18 months of operation (November 2, 1998 to May 5, 2000) in order to ascertain practical implications for organization, hospitalization and teaching.

MATERIAL AND METHODS

20.563 adult patients attended the ENT emergency clinic. Among them 1.225 were hospitalized after emergency care. Parameters analyzed were: age, sex, mode of referral to the clinic, hour and day of arrival, geographical origin, waiting time, initial signs and pathological situations encountered.

RESULTS

The most frequently observed symptoms leading to the emergency room consultation were: pain, sudden loss of hearing, bleeding, a swallowed foreign body. The most frequent nasal sign was epistaxis, the most frequent auditory condition was acute external and middle ear otitis, and the most frequent pharyngeal condition was ingestion of a foreign body. Among the 1.225 patients who were hospitalized, the most frequent conditions were epistaxis, peritonsilar phlegmon, sudden hearing loss and swallowed foreign body. Major life-threatening emergencies requiring immediate transfer to the operating room and surgery accounted for 0.5% of the patients, i.e. one "vital" emergency every 5 days.

CONCLUSIONS

Emergency ENT care for adults is an important sector of hospital activity with a mean 38 consultations per day. However, only 10% of the consultation in the emergency unit appear to be real medical emergencies. Care for many of these patients could be appropriately provided by a general practitioner, pointing out the importance of education concerning ENT disorders. There was a homogeneous distribution between men and women for the different disease conditions, except for foreign bodies which occurred more frequently in women and epistaxis and facial trauma where men predominated. Life-threatening emergencies accounted for 0.5% of all cases, i.e. one case every 5 days.