Annual epidemiologic trends of 6000 ENT cases in the Emergency Department in the post-pandemic era: a cross-sectional study from Crete, Greece

<b>Introduction:</b> The COVID-19 pandemic significantly altered healthcare-seeking trends, leading to reduced emergency department (ED) visits and changes in referral patterns. By temporally distancing from the pandemic, healthcare utilization trends might be re-explored.<b>Aim:</b> This study aims to analyze the epidemiologic trends of ear, nose, and throat (ENT) cases at the ED of a tertiary hospital in Crete, Greece, after the COVID-19 pandemic. It investigates changes in patient visit patterns, referral trends, and hospitalization rates.<b>Materials and methods:</b> A prospective design data collection was conducted on all patients examined by an ENT specialist in the ED of the tertiary hospital of Crete during 2024. Data collected included patients' demographics, diagnosis (ICD-10 coded), referrals, and patient outcomes. Specific Hospitalization Index (SHI) was calculated as a rate of the total cases admitted for a specific ICD-10 by all visits recorded for that ICD-10.<b>Results:</b> A total of 6,000 patients were examined. The most common diagnoses were acute otitis media (8.1%) and external otitis (7.0%). A total of 373 hospital admissions (6.2%) were recorded, with peritonsillar abscess (91 cases, SHI: 0.892) being the leading cause of in-hospital treatment, followed by vestibular neuronitis (29 cases, SHI: 0.617) and Bell's palsy (26 cases, SHI: 0.268). A total of 196 referrals (3.3%) were recorded, with 49.6% originating from public primary care. A decline was observed in referrals, from public primary care settings, to the same hospital, when compared with 2023 data (p = 0.013).<b>Conclusions:</b> This study underscores the significant role of ENT emergencies for ED workload, indicating a return to pre-pandemic levels of ED overcrowding. The most common diagnoses recorded provided a low SHI, suggesting that they could be managed on an outpatient basis. Future research should focus on enhancing primary care in managing ENT cases to reduce unnecessary ED visits.