J Laryngol Otol. 2016 Aug;130(8):768-76. doi: 10.1017/S0022215116008173. Epub 2016 Jun 10.
To investigate variations in the management and outcomes of peritonsillar abscesses, and to develop a trainee collaborative network in the UK.
Data were collected prospectively on suspected peritonsillar abscess cases presenting over a 2-month period at 42 participating secondary care centres, covering a population of 16 million. The primary outcome was an adverse event at 30 days, defined as re-presentation or re-drainage.
Eighteen per cent of the 325 cases experienced an adverse event. Follow-up data were valid for 90 per cent of cases. Regression analyses showed a significant reduction in adverse events in the 12 per cent of patients who were discharged within 12 hours, and there was no significant increase in adverse events for the 70 per cent receiving corticosteroids.
Out-patient management of peritonsillar abscess is not commonly practised in the UK. Corticosteroid usage is common and appears safe. This study demonstrates that trainees working in collaboration can effectively deliver prospective multicentre cohort studies in the UK.
调查扁桃体周围脓肿治疗管理及治疗结果的差异,并在英国建立一个实习医生协作网络。
前瞻性收集42个参与研究的二级医疗中心在2个月内疑似扁桃体周围脓肿病例的数据,覆盖人口达1600万。主要结局为30天内的不良事件,定义为再次就诊或再次引流。
325例病例中有18%发生了不良事件。90%的病例随访数据有效。回归分析显示,12%在12小时内出院的患者不良事件显著减少,70%接受皮质类固醇治疗的患者不良事件无显著增加。
扁桃体周围脓肿的门诊治疗管理在英国并不普遍。皮质类固醇的使用很常见且似乎是安全的。本研究表明,协作工作的实习医生能够在英国有效地开展前瞻性多中心队列研究。