{Reference Type}: Journal Article {Title}: Time to Laryngoscopy for Hoarseness in Canada: Are the American Academy of Otolaryngology Guidelines Feasible? {Author}: Howlett J;Singer J;Lee T;Hu A; {Journal}: OTO Open {Volume}: 4 {Issue}: 2 {Year}: Apr-Jun 2020 暂无{DOI}: 10.1177/2473974X20932500 {Abstract}: UNASSIGNED: To determine if a Canadian voice center is meeting the recommended time to laryngoscopy for hoarseness per the clinical practice guideline of the American Academy of Otolaryngology-Head and Neck Surgery.
UNASSIGNED: Retrospective chart audit.
UNASSIGNED: Tertiary referral Canadian voice center.
UNASSIGNED: A total of 149 adult patients presenting with hoarseness over 6 months were included. Primary outcome measures were the time from onset of symptoms to laryngoscopy and the time from referral to laryngoscopy. Secondary outcome measures included patient- and disease-modifying factors, diagnosis, and clinical management. Analysis was performed to determine what factors were associated with meeting the guideline.
UNASSIGNED: Patients were evaluated by the laryngologist after 21.9 ± 37.6 months (mean ± SD) of symptoms. One-third (34.2%) of patients were seen within 3 months; 10.7% were seen within 4 weeks. Logistic regression showed that patients with neurologic symptoms (odds ratio, 4.04; 95% CI, 1.31-12.43; P = .015) and endotracheal intubation (odds ratio, 5.94; 95% CI, 2.21-15.95; P < .001) were associated with being seen within 3 months. Patients who had recent intubation (odds ratio, 6.04; 95% CI, 1.99-18.34; P = .002) were associated with being seen within 4 weeks.
UNASSIGNED: It is an ongoing challenge for our Canadian voice center to meet the American Academy of Otolaryngology-Head and Neck Surgery's clinical practice guideline for recommended time to laryngoscopy. Patients with more severe pathologies were consistently triaged more urgently. It is debatable whether this 4-week time recommendation is generalizable to a socialized health care system.