title: Epidemiology of otologic diagnoses in United States emergency departments.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  4
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.|Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Elliott D
authors.identifier: http://orcid.org/0000-0002-0305-0682
authors.initials: ED
authors.lastname: Kozin
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.|Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Rosh K V
authors.initials: RK
authors.lastname: Sethi
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.|Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Aaron K
authors.initials: AK
authors.lastname: Remenschneider
authors.forename: Alyson B
authors.initials: AB
authors.lastname: Kaplan
authors.affiliation: Department of Emergency Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Del Portal
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Stacey T
authors.initials: ST
authors.lastname: Gray
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.|Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.|Harvard Interfaculty Initiative in Health Policy, Cambridge, Massachusetts, U.S.A.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Shrime
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.|Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003939:Diagnostic Techniques, Otological; D004427:Ear Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Otology; emergency department; resource utilization; specialized emergency care