Fadel Mark A, McCoy Jennifer L, Obuekwe Fendi, Kitsko Dennis
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States.
Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Int Arch Otorhinolaryngol. 2023 Jan 26;27(1):e152-e157. doi: 10.1055/s-0042-1758718. eCollection 2023 Jan.
For multiple reasons, elective pediatric otolaryngology surgical procedures have declined during the COVID-19 pandemic. The purpose of the present study was to assess whether the prevalence of pediatric neck abscesses managed with operative drainage decreased compared with previous years. Medical records of all pediatric cases at a tertiary care children's hospital diagnosed with abscess of the neck and treated with incision and drainage were evaluated between the dates of April 1 and November 30 from 2015 to 2020. Outcomes were compared for each year from 2015 to 2019 to 2020, which included location, abscess size, duration of antibiotic treatment, microbiology, and the number of cases per year. A total of 201 cases were included. The mean ± standard deviation (SD) presenting age in the 2015 to 2019 group was 5.05 ± 5.03 years old and 2.24 ± 1.91 years old in the 2020 group. The mean number of cases between 2015 and 2019 was 35.6 ± 4.2, whereas the number of cases in 2020 was 23 ( = 0.002). Of those patients who underwent IV antibiotic therapy prior to presentation ( = 43), the mean number of days before admission was 1.98 ± 2.95 ( = 40) from 2015 to 2019 and 12.00 ± 10.39 ( = 3) in 2020 ( = 0.008). The percent of cases with multiple strains cultured between 2015 and 2019 was 13.4% versus 18.2% in 2020 ( = 0.007). There was a decrease in the number of operative neck abscesses in 2020 compared with the mean number per year from 2015 to 2019. COVID-19 mitigation strategies leading to reduced transmission of other viral and bacterial illnesses and a tendency toward prolonged medical management to avoid surgery are two possible explanations.
由于多种原因，在新冠疫情期间，小儿耳鼻喉科择期手术的数量有所下降。本研究的目的是评估与往年相比，采用手术引流治疗的小儿颈部脓肿的患病率是否有所下降。对一家三级儿童医院在2015年4月1日至2020年11月30日期间诊断为颈部脓肿并接受切开引流治疗的所有小儿病例的病历进行了评估。比较了2015年至2019年每年与2020年的结果，包括脓肿位置、大小、抗生素治疗持续时间、微生物学以及每年的病例数。共纳入201例病例。2015年至2019年组的平均就诊年龄为5.05±5.03岁，2020年组为2.24±1.91岁。2015年至2019年的平均病例数为35.6±4.2，而2020年的病例数为23例（P = 0.002）。在就诊前接受静脉抗生素治疗的患者中（n = 43），2015年至2019年入院前的平均天数为1.98±2.95天（n = 40），2020年为12.00±10.39天（n = 3）（P = 0.008）。2015年至2019年培养出多种菌株的病例百分比为13.4%，而2020年为18.2%（P = 0.007）。与2015年至2019年每年的平均数量相比，2020年手术治疗的颈部脓肿数量有所减少。导致其他病毒和细菌疾病传播减少的新冠疫情缓解策略以及倾向于延长药物治疗以避免手术是两种可能的解释。
