{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T17:51:32Z","timestamp":1760205092876},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T00:00:00Z","timestamp":1608163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To report changes in practice brought about by COVID\u201019 and the implementation of new guidelines for the management of tonsillitis and peritonsillar abscess (PTA), and to explore factors relating to unscheduled re\u2010presentations for patients discharged from the emergency department (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective multicentre national audit over 12\u00a0weeks from 6 April 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>UK secondary care ENT departments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adult patients with acute tonsillitis or PTA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Re\u2010presentation within 10\u00a0days for patients discharged from the ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>83 centres submitted 765 tonsillitis and 416 PTA cases. 54.4% (n\u00a0=\u00a0410) of tonsillitis and 45.3% (187\/413) of PTAs were discharged from ED. 9.6% (39\/408) of tonsillitis and 10.3% (19\/184) of PTA discharges re\u2010presented within 10\u00a0days, compared to 9.7% (33\/341) and 10.6% (24\/224) for those admitted from ED. The subsequent admission rate of those initially discharged from ED was 4.7% for tonsillitis and 3.3% for PTAs.<\/jats:p><jats:p>IV steroids and antibiotics increased the percentage of patients able to swallow from 35.8% to 72.5% for tonsillitis (n\u00a0=\u00a0270\/754 and 441\/608) and from 22.3% to 71.0% for PTA (n\u00a0=\u00a092\/413 and 265\/373).<\/jats:p><jats:p>77.2% of PTAs underwent drainage (n\u00a0=\u00a0319\/413), with no significant difference in re\u2010presentations in those drained vs not\u2010drained (10.6% vs 9.5%, n\u00a0=\u00a015\/142 vs 4\/42, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.846).<\/jats:p><jats:p>Univariable logistic regression showed no significant predictors of re\u2010presentation within 10\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Management of tonsillitis and PTA changed during the initial peak of the pandemic, shifting towards outpatient care. Some patients who may previously have been admitted to hospital may be safely discharged from the ED.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13680","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T04:27:06Z","timestamp":1606969626000},"page":"363-372","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Admission avoidance in tonsillitis and peritonsillar abscess: A prospective national audit during the initial peak of the COVID\u201019 pandemic"],"prefix":"10.1111","volume":"46","author":[{"name":"INTEGRATE (The UK ENT Trainee Research Network)","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"NHS Digital.NHS hospital episode statistics in England and Wales.2017."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2606.200516"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-020-00425-6"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22577"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa149"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215120001413"},{"key":"e_1_2_10_8_1","unstructured":"McNallyG BurgessA AgrawalS et al.ENT UK COVID\u201019 adult tonsillitis & quinsy guidelines.2020."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_10_10_1","article-title":"Admission avoidance in acute epistaxis: a prospective national audit during the initial peak of the COVID\u201019 pandemic","author":"INTEGRATE (The UK ENT research trainee network)","year":"2020","journal-title":"Clin Otolaryngol"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2020.06.003"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0042136"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.2174\/187152612801319230"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116008173"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2052-8"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6923e1"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12299"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12620"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12753"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24936"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1258\/002221504323219563"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24283"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820927328"},{"key":"e_1_2_10_24_1","unstructured":"National Institute for Health and Clinical Excellence.Clinical knowledge summary: sore throat \u2010 acute.2018."}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13680","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.13680","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13680","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T01:08:20Z","timestamp":1692580100000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.13680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,17]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1111\/coa.13680"],"URL":"https:\/\/doi.org\/10.1111\/coa.13680","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,17]]},"assertion":[{"value":"2020-09-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}