Dataset Information

Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study.

ABSTRACT:

Objectives

To explore the impact of COVID-19 on the management and outcomes of acute paediatric mastoiditis across the UK.

Design

National retrospective and prospective audit.

Setting

48 UK secondary care ENT departments.

Participants

Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis.

Main outcome measures

Cases were divided into Period 1 (01/11/19-15/03/20), before the UK population were instructed to reduce social contact, and Period 2 (16/03/20-30/04/21), following this. Periods 1 and 2 were compared for population variables, management and outcomes. Secondary analyses compared outcomes by primary treatment (medical/needle aspiration/surgical).

Results

286 cases met criteria (median 4 per site, range 0-24). 9.4 cases were recorded per week in period 1 versus 2.0 in period 2, with no winter increase in cases in December 2020-Febraury 2021. Patient age differed between periods 1 and 2 (3.2 vs 4.7 years respectively, p < 0.001). 85% of children in period 2 were tested for COVID-19 with a single positive test. In period, 2 cases associated with P. aeruginosa significantly increased. 48.6% of children were scanned in period 1 vs 41.1% in period 2. Surgical management was used more frequently in period 1 (43.0% vs 24.3%, p = 0.001). Treatment success was high, with failure of initial management in 6.3%, and 30-day re-admission for recurrence in 2.1%. The adverse event rate (15.7% overall) did not vary by treatment modality or between periods 1& 2.

Conclusion

The COVID-19 pandemic led to a significant change in the presentation and case mix of acute paediatric mastoiditis in the UK.

SUBMITTER: Smith ME

PROVIDER: S-EPMC8652842 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study.

Smith Matthew E ME Jones G Huw GH Hardman John C JC Nichani Jaya J Khwaja Sadie S Bruce Iain A IA Rea Peter P

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 20211103 1

<h4>Objectives</h4>To explore the impact of COVID-19 on the management and outcomes of acute paediatric mastoiditis across the UK.<h4>Design</h4>National retrospective and prospective audit.<h4>Setting</h4>48 UK secondary care ENT departments.<h4>Participants</h4>Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis.<h4>Main outcome measures</h4>Cases were divided into Period 1 (01/11/19-15/03/20), before the UK population were instructed to reduce ...[more]

PMID: 34606691

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Project description:ObjectivesPatients with severe acute respiratory distress syndrome may require veno-venous extracorporeal membrane oxygenation (V-V ECMO) support. For patients in peripheral hospitals, retrieval by mobile ECMO teams and transport to high-volume centers is associated with improved outcomes, including the recent COVID-19 pandemic. To enable a safe transport of patients, a specialised ECMO-retrieval program needs to be implemented. However, there is insufficient evidence on how to safely and efficiently perform ECMO retrievals. We report single-centre data from out-of-centre initiations of VV-ECMO before and during the COVID-19 pandemic.Design & settingSingle-centre retrospective study. We include all the retrievals performed by our ECMO centre between January 1st, 2014, and April 30th, 2021.ResultsOne hundred ECMO missions were performed in the study period, for a median retrieval volume of 13 (IQR: 9-16) missions per year. the cause of the acute respiratory distress syndrome was COVID-19 in 10 patients (10 %). 98 (98 %) patients were retrieved and transported to our ECMO centre. To allow safe transport, 91 of them were cannulated on-site and transported on V-V ECMO. The remaining seven patients were centralised without ECMO, but they were all connected to V-V ECMO in the first 24 hours. No complications occurred during patient transport. The median duration of the ECMO mission was 7 hours (IQR: 6-9, range: 2 - 17). Median duration of ECMO support was 14 days (IQR: 9-24), whereas the ICU stay was 24 days (IQR:18-44). Overall, 73 patients were alive at hospital discharge (74 %). Survival rate was similar in non-COVID-19 and COVID-19 group (73 % vs 80 %, p = 0.549).ConclusionIn this single-centre experience, before and during COVID-19 era, retrieval and ground transportation of ECMO patients was feasible and was not associated with complications. Key factors of an ECMO retrieval program include a careful selection of the transport ambulance, training of a dedicated ECMO mobile team and preparation of specific checklists and standard operating procedures.

Dataset Information

Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study.

Objectives

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Publications

Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study.

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