Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America.
Eur Arch Otorhinolaryngol. 2022 Feb;279(2):1053-1062. doi: 10.1007/s00405-021-06963-7. Epub 2021 Jul 10.
To identify areas of critical otolaryngology contributions to inpatient care resistant to disruption by the COVID-19 pandemic.
Medical records of 614 otolaryngology consults seen between January and June of 2019 and 602 seen between January and June of 2020 were reviewed. Extracted data included patient demographics, SARS-CoV-2 status, medical comorbidities, consult location, consult category, reason for consult, procedures performed, and overall outcome. Prevalence of data items was compared using t tests and Chi-squared tests.
The number of monthly consults to the otolaryngology service remained approximately stable after the onset of the COVID-19 pandemic. However, there was a substantial increase in ICU consults and a decrease in ER and floor consults. The proportion of otology, rhinology, and head and neck consults decreased while that of airway consults-most of which were tracheostomy-related-greatly increased. While the top ten reasons for consult remained essentially the same, they dramatically increased as a percentage of consults during COVID-19 (55-92%), whereas there was a dramatic decrease in the proportion of less frequent consults.
The changes in otolaryngology consultation patterns seen after the onset of the pandemic are multifactorial, but may be attributed to novel pathologies, attitudes, and policies. Nonetheless, these patterns reveal that a set of core otolaryngologic issues, including acute airway issues, head and neck lesions, severe sinusitis and epistaxis, are essential and need to be addressed in the inpatient setting, whereas the significant drop in other consults suggests that they may be appropriately managed on an outpatient basis.
确定耳鼻喉科学对住院患者护理的重要贡献领域，这些领域不易受到 COVID-19 大流行的干扰。
回顾了 2019 年 1 月至 6 月和 2020 年 1 月至 6 月期间的 614 次耳鼻喉科会诊和 602 次会诊的医疗记录。提取的数据包括患者人口统计学特征、SARS-CoV-2 状态、合并症、会诊地点、会诊类别、会诊原因、进行的程序和总体结果。使用 t 检验和卡方检验比较数据项目的发生率。
COVID-19 大流行后，耳鼻喉科会诊服务的每月会诊次数基本保持稳定。然而，重症监护病房的会诊显著增加，急诊室和病房的会诊减少。耳科学、鼻科学和头颈部会诊的比例下降，而气道会诊的比例增加，其中大多数与气管切开术相关。虽然前 10 个会诊原因基本相同，但在 COVID-19 期间，它们占会诊的百分比急剧增加（55%-92%），而不太常见的会诊比例则大幅下降。
大流行后耳鼻喉科会诊模式的变化是多方面的，但可能归因于新的病理、态度和政策。尽管如此，这些模式表明，一组核心耳鼻喉科问题，包括急性气道问题、头颈部病变、严重鼻窦炎和鼻出血，是必不可少的，需要在住院环境中得到解决，而其他会诊的显著减少表明它们可能适合在门诊管理。
