North East London coronavirus disease 2019 protocol for diagnostics in two-week wait head and neck cancer patients

Autor: K Ghufoor, P Richards, J Ahmed, Ashok Adams, D W Scholfield, S Ali, E Warner
Rok vydání: 2020
Předmět:
Diagnostic Imaging
medicine.medical_specialty
Delayed Diagnosis
Coronavirus disease 2019 (COVID-19)
Squamous Cell Carcinoma Of Head And Neck
Biopsy
Fine-Needle
Pneumonia
Viral
Histopathology
North east
Risk Assessment
Betacoronavirus
03 medical and health sciences
0302 clinical medicine
Clinical Protocols
Positron Emission Tomography Computed Tomography
London
Pandemic
medicine
Humans
Thyroid Neoplasms
Thyroid Nodule
030223 otorhinolaryngology
Pandemics
Referral and Consultation
Ultrasonography
Interventional
Management practices
Aerosols
Protocol (science)
Surgical approach
SARS-CoV-2
business.industry
Head and neck cancer
Main Articles
COVID-19
Head And Neck Neoplasms
General Medicine
medicine.disease
Otorhinolaryngologic Surgical Procedures
Otorhinolaryngology
030220 oncology & carcinogenesis
Emergency medicine
Feasibility Studies
Coronavirus Infections
Risk assessment
business
Zdroj: The Journal of Laryngology and Otology
The Journal of Laryngology & Otology
ISSN: 1748-5460
0022-2151
DOI: 10.1017/s0022215120001267
Popis: BackgroundThe coronavirus disease 2019 pandemic requires urgent modification to existing head and neck cancer diagnosis and management practices. A protocol was established that utilises risk stratification, early investigation prior to clinical review and a reduction in aerosol generating procedures to lessen the risk of coronavirus disease 2019 spread.MethodsTwo-week wait referrals were stratified into low, intermediate and high risk. Low risk patients were referred back to primary care with advice; intermediate and high risk patients underwent investigation. Clinical encounters and aerosol generating procedures were minimised. A combined diagnostic and therapeutic surgical approach was undertaken where possible.ResultsForty-one patients were used to assess feasibility. Thirty-one per cent were low risk, 35 per cent were intermediate and 33 per cent were high risk. Thirty-three per cent were discharged with no imaging.ConclusionImplementing this protocol reduces the future burden on tertiary services, by empowering primary care physicians to re-refer low risk patients. The protocol is applicable across the UK and avoids diagnostic delay.
Databáze: OpenAIRE
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