■根据美国耳鼻咽喉头颈外科学会的临床实践指南,确定加拿大语音中心是否符合建议的喉镜检查时间。
■回顾性图表审计。
■三级转诊加拿大语音中心。
■共149名6个月以上出现声音嘶哑的成年患者。主要结局指标是从症状发作到喉镜检查的时间和从转诊到喉镜检查的时间。次要结局指标包括患者和疾病改变因素,诊断,和临床管理。进行分析以确定哪些因素与满足指南相关。
■患者在21.9±37.6个月(平均值±SD)症状后由喉科医师进行评估。三分之一(34.2%)的患者在3个月内就诊;10.7%在4周内就诊。Logistic回归显示,有神经系统症状的患者(比值比,4.04;95%CI,1.31-12.43;P=.015)和气管插管(比值比,5.94;95%CI,2.21-15.95;P<.001)与3个月内出现相关。最近插管的患者(赔率比,6.04;95%CI,1.99-18.34;P=.002)与4周内的观察相关。
■对于我们的加拿大语音中心来说,满足美国耳鼻咽喉头颈外科学会关于喉镜检查时间建议的临床实践指南是一项持续的挑战。病理更严重的患者始终被更紧急地分类。这项为期4周的建议是否可推广到社会化的医疗保健系统,尚有争议。
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.