Kozin Elliott D, Sethi Rosh K V, Remenschneider Aaron K, Kaplan Alyson B, Del Portal Daniel A, Gray Stacey T, Shrime Mark G, Lee Daniel J
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Laryngoscope. 2015 Aug;125(8):1926-33. doi: 10.1002/lary.25197. Epub 2015 Feb 20.
OBJECTIVES/HYPOTHESIS: Otologic complaints may place a significant burden on emergency departments (EDs) in the United States; however, few studies have comprehensively examined this discrete patient population. We aimed to identify utilization of EDs by patients with primary otologic complaints.
Retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011.
The NEDS database was queried for patient encounters with a primary otologic diagnosis based on International Classification of Diseases, Ninth Revision codes (380-389). Weighted estimates for demographics, diagnostic characteristics, socioeconomic status, and trends over time were extracted. Predictors of mortality and admission were determined by multivariable logistic regression.
A weighted total of 8,611,282 visits between 2009 and 2011 were attributed to otologic diagnoses, representing 2.21% of all ED visits. Stratified by patient age, otologic diagnoses encompassed 1.01% and 6.79% of all adult and pediatric ED visits, respectively. The majority of patients were treated and released (98.17%). The average age of patients presenting with an otologic complaint was 17.9 years (standard error = 0.23). Overall, 62.7% of patients who presented with an otologic complaint were 0 to 17 years old. The most common diagnoses among all age groups included otitis media not otherwise specified (NOS) (60.6%), infected otitis externa NOS (11.8%), and otalgia NOS (6.8%).
We provide a comprehensive overview of otologic complaints that are an overlooked diagnostic category in public health research. NEDS data demonstrate a significant number of visits related to otologic complaints, especially in the pediatric population, that are nonemergent.
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目的/假设：耳部疾病相关的就诊诉求可能给美国急诊科带来沉重负担；然而，很少有研究全面调查过这一特定患者群体。我们旨在确定以耳部疾病为主诉的患者对急诊科的利用率。
对2009年至2011年全国急诊科样本（NEDS）进行回顾性分析。
根据国际疾病分类第九版编码（380 - 389），在NEDS数据库中查询以耳部疾病为主诊断的患者就诊情况。提取人口统计学、诊断特征、社会经济状况及随时间变化趋势的加权估计值。通过多变量逻辑回归确定死亡率和住院的预测因素。
2009年至2011年期间，加权后总计8611282次就诊归因于耳部疾病诊断，占所有急诊科就诊人次的2.21%。按患者年龄分层，耳部疾病诊断分别占所有成人和儿科急诊科就诊人次的1.01%和6.79%。大多数患者接受治疗后出院（98.17%）。耳部疾病主诉患者的平均年龄为17.9岁（标准误 = 0.23）。总体而言，62.7%的耳部疾病主诉患者年龄在0至17岁之间。所有年龄组中最常见的诊断包括未另行特指的中耳炎（NOS）（60.6%）、未另行特指的感染性外耳道炎（11.8%）和未另行特指的耳痛（6.8%）。
我们提供了耳部疾病相关就诊诉求的全面概述，这是公共卫生研究中一个被忽视的诊断类别。NEDS数据显示，与耳部疾病相关就诊诉求的就诊人次众多，尤其是在儿科人群中，且多为非紧急情况。
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