Emergency department visits, hospitalizations, and readmissions of patients with a peritonsillar abscess.

OBJECTIVES: To determine the demographics and treatment outcomes of patients with a peritonsillar abscess (PTA) and to provide guidance for treatment options.

METHODS: The 2012 National Emergency Department Database, 2012 National Inpatient Sample, and 2013 Nationwide Readmissions Database were used to analyze patients with a PTA who presented to emergency departments (ED), were admitted and/or readmitted to hospitals in the United States. Outcomes were used to create a decision model to compare initial medical versus surgical management.

RESULTS: An estimated 62,787 ED visits; 15,095 inpatient admissions; and 267 readmissions for PTA were recorded. The average age was 29 years old, with a slight male predominance. The majority of patients seen in the ED (80%) were treated without surgery and discharged home. Patients admitted to hospital were more likely to undergo surgery (50%). The tonsillectomy rate was 11%. The complication and readmission rates were < 2%. Medical therapy was used more often than surgical therapy in many cases.

CONCLUSION: Peritonsillar abscess mostly occurs in adults and leads to a significant number of ED visits, admissions, and readmissions. A trial of medical management of PTA appears to be safe, although surgery is highly successful and associated with low morbidity.

LEVEL OF EVIDENCE: 2c. Laryngoscope, 127:S1-S9, 2017.