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Multicenter Study
. 2015 Aug;125(8):1926-33.
doi: 10.1002/lary.25197. Epub 2015 Feb 20.

Epidemiology of otologic diagnoses in United States emergency departments

Elliott D Kozin  1   2 , Rosh K V Sethi  1   2 , Aaron K Remenschneider  1   2 , Alyson B Kaplan, Daniel A Del Portal  3 , Stacey T Gray  1 , Mark G Shrime  1   2   4 , Daniel J Lee  1   2
Affiliations
Multicenter Study

Epidemiology of otologic diagnoses in United States emergency departments

Elliott D Kozin et al. Laryngoscope. 2015 Aug.

Abstract

Objectives/hypothesis: Otologic complaints may place a significant burden on emergency departments (EDs) in the United States; however, few studies have comprehensively examined this discrete patient population. We aimed to identify utilization of EDs by patients with primary otologic complaints.

Study design: Retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011.

Methods: The NEDS database was queried for patient encounters with a primary otologic diagnosis based on International Classification of Diseases, Ninth Revision codes (380-389). Weighted estimates for demographics, diagnostic characteristics, socioeconomic status, and trends over time were extracted. Predictors of mortality and admission were determined by multivariable logistic regression.

Results: A weighted total of 8,611,282 visits between 2009 and 2011 were attributed to otologic diagnoses, representing 2.21% of all ED visits. Stratified by patient age, otologic diagnoses encompassed 1.01% and 6.79% of all adult and pediatric ED visits, respectively. The majority of patients were treated and released (98.17%). The average age of patients presenting with an otologic complaint was 17.9 years (standard error = 0.23). Overall, 62.7% of patients who presented with an otologic complaint were 0 to 17 years old. The most common diagnoses among all age groups included otitis media not otherwise specified (NOS) (60.6%), infected otitis externa NOS (11.8%), and otalgia NOS (6.8%).

Conclusions: We provide a comprehensive overview of otologic complaints that are an overlooked diagnostic category in public health research. NEDS data demonstrate a significant number of visits related to otologic complaints, especially in the pediatric population, that are nonemergent.

Level of evidence: 4

Keywords: Otology; emergency department; resource utilization; specialized emergency care.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Monthly variation in volume of primary otologic-related visits to hospital-based emergency departments in the United States (2009 to 2011). *Error bars denote standard deviation of weighted frequency.
Figure 2
Figure 2
Monthly variation in primary diagnoses of otitis media and otitis externa in hospital-based emergency departments in the United States (2009–2011).
Figure 3
Figure 3
National weighted estimates for incidence of primary otologic visits to hospital-based EDs by census-defined regions of the United States (2009–2011).
See this image and copyright information in PMC

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