title: Pediatric peritonsillar abscess: Outcomes and cost savings from using transcervical ultrasound.
abstract: 1) To analyze clinical outcomes of children stratified by ultrasound into three diagnoses: acute tonsillitis, peritonsillar phlegmon, and abscess; and 2) To compare clinical outcomes and financial impact between children who underwent ultrasound protocol to those who did not.
  
  
  
  Retrospective analysis between two cohorts: ultrasound protocol group and control group.
  
  
  
  Children with peritonsillar abscess (PTA) diagnosed in the emergency department (ED) were enrolled during a 2-year period for transcervical ultrasound evaluation of bilateral tonsillar fossae. Data from a cohort of patients with PTA prior to ultrasound screening were also collected from retrospective chart review. Outcome variables were analyzed using multivariate logistic regression.
  
  
  
  Seventy-eight children (mean 12.3 years) were enrolled in the ultrasound protocol, compared to 101 children (mean 13.6 years) evaluated using traditional methods of examination and/or computed tomography (CT) imaging. Demographics between the two groups were not significantly different. Only one-third of patients presumed to have PTA by ED staff had ultrasound findings consistent with abscess. Overall treatment failure rate was 8%, requiring readmission or surgical intervention for abscess. Length of stay, surgical drainage, and radiation exposure from CT scans were reduced significantly in the ultrasound group (P < 0.006). Differences in readmission rates and mean charges between the two groups did not reach significance.
  
  
  
  Peritonsillar abscess is a common infection in the pediatric population, but diagnosis can be challenging. Transcervical ultrasound is a safe, cost-effective, and accurate modality to help stratify patients into medical and surgical treatment arms.
  
  
  
  3b. Laryngoscope, 127:1924-1929, 2017.
authors.affiliation: Department of Otorhinolaryngology, University of Texas-Health Science Center at Houston, Houston, Texas, U.S.A.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huang
authors.affiliation: George Washington University School of Medicine and Health Sciences.
authors.forename: William
authors.initials: W
authors.lastname: Vintzileos
authors.affiliation: the Department of Integrative Systems Biology and Pediatrics.
authors.forename: Heather
authors.initials: H
authors.lastname: Gordish-Dressman
authors.affiliation: the Department of Radiology.
authors.forename: Anjum
authors.initials: A
authors.lastname: Bandarkar
authors.affiliation: the Department of Pediatric Otolaryngology , George Washington University School of Medicine and Health Sciences, Children's National Health System, Washington, DC.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Reilly
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017046:Cost Savings; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D000039:Peritonsillar Abscess / Q000000981:diagnostic imaging* / Q000191:economics*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography / Q000191:economics*; D055815:Young Adult
keywords: CT; Ultrasound; cost savings; peritonsillar abscess