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Time to Laryngoscopy for Hoarseness in Canada: Are the American Academy of Otolaryngology Guidelines Feasible?
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo 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. STUDY
designRetrospective chart audit.
settingTertiary referral Canadian voice center. PARTICIPANTS AND
methodsA 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.
resultsPatients 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;
conclusionIt 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.
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