Abstract：
OBJECTIVE: Peritonsillar abscess (PTA) is a common deep space head and neck infection, which can be diagnosed with or without computed tomography (CT). CT poses a risk for false positives, leading to unnecessary abscess drainage attempts without benefit, whereas needle or open aspiration without imaging could potentially lead to missed abscess in need of treatment. This study considered the utility and impact of obtaining CT scans in patients with suspected PTA by comparing outcomes between CT and non-CT usage.
METHODS: Retrospective cohort analysis using TriNetX datasets compared the outcomes of two cohorts: PTA without CT and PTA with CT. Measured outcomes included incision and drainage; quinsy adenotonsillectomy; recurrent PTA; airway emergency/obstruction; repeat emergency department (ED) visits; and need for antibiotics, opiates, or steroids. Odds ratios (OR) were calculated using a cohort analysis.
RESULTS: The CT usage group had increased odds of receiving antibiotics (OR 3.043, [2.043-4.531]), opiates (OR 1.614, [1.138-1.289]), and steroids (OR 1.373, [1.108-1.702]), as well as a higher likelihood of returning to the ED (OR 5.900, [3.534-9.849]) and developing a recurrent PTA (OR 1.943, [1.410-2.677]). No significant differences were observed in the incidence of incision and drainage, quinsy adenotonsillectomy, or airway emergency/obstruction.
CONCLUSIONS: Our study indicated that CT scans for PTA diagnosis were associated with increased prescription of antibiotics, opioids, steroids, return ED visits, and recurrent PTA. Future prospective trials are needed to determine if the use of CT scans indicates higher patient acuity that explains the potential negative outcomes.
METHODS: Level II Laryngoscope, 2024.
METHODS: Retrospective cohort analysis using TriNetX datasets compared the outcomes of two cohorts: PTA without CT and PTA with CT. Measured outcomes included incision and drainage; quinsy adenotonsillectomy; recurrent PTA; airway emergency/obstruction; repeat emergency department (ED) visits; and need for antibiotics, opiates, or steroids. Odds ratios (OR) were calculated using a cohort analysis.
RESULTS: The CT usage group had increased odds of receiving antibiotics (OR 3.043, [2.043-4.531]), opiates (OR 1.614, [1.138-1.289]), and steroids (OR 1.373, [1.108-1.702]), as well as a higher likelihood of returning to the ED (OR 5.900, [3.534-9.849]) and developing a recurrent PTA (OR 1.943, [1.410-2.677]). No significant differences were observed in the incidence of incision and drainage, quinsy adenotonsillectomy, or airway emergency/obstruction.
CONCLUSIONS: Our study indicated that CT scans for PTA diagnosis were associated with increased prescription of antibiotics, opioids, steroids, return ED visits, and recurrent PTA. Future prospective trials are needed to determine if the use of CT scans indicates higher patient acuity that explains the potential negative outcomes.
METHODS: Level II Laryngoscope, 2024.
摘要：
目的：扁桃体周围脓肿（PTA）是一种常见的头颈部深间隙感染，可以诊断有或没有计算机断层扫描（CT）。CT有假阳性的风险,导致不必要的脓肿引流尝试没有好处，而没有成像的针吸或开放抽吸可能会导致需要治疗的脓肿错过。本研究通过比较CT和非CT使用的结果，考虑了对疑似PTA患者进行CT扫描的实用性和影响。
方法：使用TriNetX数据集的回顾性队列分析比较了两个队列的结果：无CT的PTA和有CT的PTA。测量结果包括切口和引流术；腹股沟腺扁桃体切除术；复发性PTA；气道急诊/阻塞；重复急诊（ED）就诊；以及需要抗生素，阿片类药物,或者类固醇.使用队列分析计算赔率比(OR)。
结果：CT使用组接受抗生素的几率增加（OR3.043，[2.043-4.531]），阿片类药物（OR1.614，[1.138-1.289]），和类固醇（OR1.373，[1.108-1.702]），以及返回ED的可能性较高（OR5.900，[3.534-9.849]）并发生复发性PTA（OR1.943，[1.410-2.677]）。切口和引流的发生率无显著差异，昆西腺扁桃体切除术，或气道急症/阻塞。
结论：我们的研究表明，用于PTA诊断的CT扫描与抗生素处方的增加有关，阿片类药物,类固醇,返回ED访问，和复发性PTA。需要进行未来的前瞻性试验，以确定CT扫描的使用是否显示更高的患者视力，从而解释潜在的负面结果。
方法：II级喉镜，2024.
方法：使用TriNetX数据集的回顾性队列分析比较了两个队列的结果：无CT的PTA和有CT的PTA。测量结果包括切口和引流术；腹股沟腺扁桃体切除术；复发性PTA；气道急诊/阻塞；重复急诊（ED）就诊；以及需要抗生素，阿片类药物,或者类固醇.使用队列分析计算赔率比(OR)。
结果：CT使用组接受抗生素的几率增加（OR3.043，[2.043-4.531]），阿片类药物（OR1.614，[1.138-1.289]），和类固醇（OR1.373，[1.108-1.702]），以及返回ED的可能性较高（OR5.900，[3.534-9.849]）并发生复发性PTA（OR1.943，[1.410-2.677]）。切口和引流的发生率无显著差异，昆西腺扁桃体切除术，或气道急症/阻塞。
结论：我们的研究表明，用于PTA诊断的CT扫描与抗生素处方的增加有关，阿片类药物,类固醇,返回ED访问，和复发性PTA。需要进行未来的前瞻性试验，以确定CT扫描的使用是否显示更高的患者视力，从而解释潜在的负面结果。
方法：II级喉镜，2024.
