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Impact of the COVID-19 pandemic on acute otolaryngology inpatient activity at a tertiary referral centre: a retrospective analysis.
  • Praveena Deekonda,
  • Adal Mirza,
  • Huw Jones
Praveena Deekonda
Southampton General Hospital
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Adal Mirza
Southampton General Hospital
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Huw Jones
Southampton General Hospital
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Abstract

Objective To determine the impact of the COVID-19 pandemic on acute admissions and inpatient activity at a tertiary referral centre. Design Retrospective review of coding-based inpatient electronic records. Setting An otolaryngology and head and neck surgery department at a UK major trauma and tertiary referral centre. Participants Otolaryngology patients admitted as an emergency over a period of 12 months pre-COVID19 (01/04/2019-31/03/2020) and 10 months post-COVID19 (01/04/2020-23/01/2021). Main outcome measures Baseline characteristics, admission rates, length of stay (LoS), overall mortality and 30-day mortality. Results 1844 records were reviewed; (1293 pre-COVID19, 551 post-COVID19). Admissions across all age groups were reduced, with an increase in mean age from 40.4 to 47.4 years (p=0.001). LoS remained unchanged (3.74 vs 3.82 days, p=0.251). Epistaxis remained the most common presentation, with an increased LoS compared to the pre-COVID19 cohort. GP referrals reduced from 18.0% to 4.2% (n=233 vs n=23, p<0.001) and ED referrals proportionally increased from 60.9% to 75.3%, n=787 vs n=417, p<0.001). Critical care admissions were higher in the post-COVID19 cohort (OR 1.82 (1.11-2.99) [95% CI], p=0.017). There was no significant difference in overall mortality between groups (n=74, 5.7% vs. n=33, 6.0%; p=0.844). Thirty-day mortality increased from 0.9% (n=12) pre-COVID19 to 2.3% (n=13) post-COVID19 (p=0.03). Conclusions This study demonstrates significant changes and a reduction in acute otolaryngology presentations. Our findings suggest that sicker, frailer patients were admitted during the pandemic. This study highlights important considerations for acute otolaryngology care moving forward after the pandemic.
02 Aug 2021Submitted to Clinical Otolaryngology
05 Aug 2021Submission Checks Completed
05 Aug 2021Assigned to Editor
12 Aug 2021Reviewer(s) Assigned
24 Aug 2021Review(s) Completed, Editorial Evaluation Pending
05 Sep 2021Editorial Decision: Revise Major
03 Dec 20211st Revision Received
21 Dec 2021Assigned to Editor
21 Dec 2021Submission Checks Completed
06 Jan 2022Reviewer(s) Assigned
16 Jan 2022Review(s) Completed, Editorial Evaluation Pending
23 Jan 2022Editorial Decision: Revise Minor
02 Feb 20222nd Revision Received
03 Feb 2022Submission Checks Completed
03 Feb 2022Assigned to Editor
08 Feb 2022Reviewer(s) Assigned
09 Feb 2022Review(s) Completed, Editorial Evaluation Pending
13 Feb 2022Editorial Decision: Accept
04 Mar 2022Published in Clinical Otolaryngology. 10.1111/coa.13920