A Prospective Audit of Acute ENT Activity in a Teaching Hospital.

Introduction and aim: Acute ENT coverage is available out-of-hours in most hospitals. However, increasing pressure to reduce healthcare cost threatens this service provision round the clock. Our goal was to audit the emergency ENT activity in our institution over a one-month period

Material and methods: a prospective audit for all ENT referrals from the emergency department was carried out from May 1st to May 31th 2017. Descriptive statistics were produced for age, sex, origin, time of arrival, diagnosis and patient outcome.

Results: a total of 190 patients (109 men and 81 women) were referred to the ENT emergency service over the study period (mean 6.1 case per day). Mean age was 47.9 (±23.6)year (range 1-95). Most patients were ambulatory (75.8%) and came from the area. Most admissions occurred during normal working hours (76.4%) and 62.0% patients came by self reference. The mean complaint duration before admission was 7.6 (±13.7) days (range 0-92 days). One third (33.2% patients) required ambulatory treatment. A quarter (24.7% patients) underwent a minor ENT procedure. Eighteen (9.5%) patients required admission to the ward (mostly for intravenous antibiotic). Eight patients (4.2%) required surgical treatment. There was no difference in the severity of diagnosis or management between patients referred by a physician (GP of specialist) and patients presenting spontaneously. At 30 days, 3 (1.6%) patients died (one of ENT cancer, two of unrelated cause), 106 (55.8%) benefited from an ENT follow’up, 65 (34.2%) were referred to another physician (GP or specialist), 16 (8.4%) were lost to follow’up.

Conclusions: The workload suggests that emergency ENT activity is justified in our hospital. Restricting emergency ENT cover to patients referred by a GP or another physician would not allow for a better patient selection.