Rhinologic Emergencies: a Prospective Audit in a University Teaching Hospital

Aims: Increasing pressure to reduce healthcare cost threatens the provision of acute ENT coverage round the clock. Our goal was to audit our emergency rhinologic activity over a one-month period.
Methods: A prospective audit for all emergency ENT referrals was carried out from May 1st to May 31th 2017. Descriptive statistics were produced for age, sex, origin, time of arrival, diagnosis and outcome. A specific subgroup analysis was performed for rhinologic emergencies. A basic cost analysis was ran.
Results: Over the study period, 190 patients were referred to the ENT emergency service. Twenty percent patients presented with nose or sinus complaint (36.8% with otological or neuro-vestibular primary complaint, 43.2% with laryngeal or neck complaint). Nose and throat complaints were more likely to present at night or on weekends. Ear complaints were more likely to present during business hours. Rhinologic complaint was more likely to require technical or surgical management than ear or throat complaint. Patients with nose complaint required minor procedure in 43.2% cases (35.6% of the total minor procedures), and required surgical procedure in 13.5% cases. Among the total ENT emergency surgical procedures, 62.5% were rhinologic ones, involving the nose (50%) or the sinus (12.5%). Ear or throat initial complaint were more likely to require no treatment or ambulatory management.

Conclusion: The emergency rhinologic activity is justified in our hospital. An initial rhinological complaint was more likely to require specific ENT management than other complaints. ENT cover is an efficient service provision, especially for rhinologic emergencies.