The dental triage method at Rothschild Hospital during the first lockdown due to the COVID-19 pandemic

Yara Saade, Muriel de la Dure Molla, Benjamin Fournier, Stéphane Kerner, Pierre Colon, Maria Clotilde Carra and Philippe Bouchard
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Yara Saade: CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université, Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU) - INSERM - Institut National de la Santé et de la Recherche Médicale - UPCité - Université Paris Cité
Muriel de la Dure Molla: Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU) - INSERM - Institut National de la Santé et de la Recherche Médicale - UPCité - Université Paris Cité, CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université
Benjamin Fournier: CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université, CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers - EPHE - École Pratique des Hautes Études - PSL - Université Paris Sciences et Lettres - INSERM - Institut National de la Santé et de la Recherche Médicale - SU - Sorbonne Université - UPCité - Université Paris Cité
Stéphane Kerner: CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université, Loma Linda University
Pierre Colon: CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université, LMI - Laboratoire des Multimatériaux et Interfaces - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - INC-CNRS - Institut de Chimie - CNRS Chimie - CNRS - Centre National de la Recherche Scientifique
Maria Clotilde Carra: CONSTANCES - Cohortes épidémiologiques en population - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay - UPCité - Université Paris Cité, CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université
Philippe Bouchard: CHU Rothschild [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université, URP 2496 - Pathologies, imagerie et biothérapies oro-faciales = Orofacial pathologies, imaging and biotherapies - UPCité - Université Paris Cité

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Abstract: Objective: This study aims to (1) assess the efficacy of a face-to-face emergency protocol in children and adults and (2) measure the efficacies of prediagnosis at the triage level and clinical diagnosis at the emergency department level during the COVID-19 pandemic. Methods: A triage protocol was applied for patients at the entry of the Rothschild Hospital (AP-HP) between March 18th and May 11th, 2020. First, patients underwent a triage based on self-reported symptoms. If their condition was deemed urgent, they were oriented toward dental professionals, who performed an intraoral examination leading to a clinical diagnosis. Triage and diagnoses were categorized into four emergency groups: infectious, prosthetic, traumatic, and others. The agreement between triage and clinical diagnosis was tested (χ2 test). Positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity for each diagnostic category were assessed to evaluate the performance and efficacy of the triage. Results: Out of 1562 dental visits, 1064 were included in this analysis. The most frequently reported symptoms by children at triage were pain (31.5%) and trauma (22%). Adults mainly complained of abscesses (45.1%) and pulpitis (20.5%). The most frequent clinical diagnoses were abscesses (29.2%) and pulpitis (20.5%) among children and adults, respectively. Tooth extraction was the most frequent treatment modality. Systemic antibiotics were prescribed for 49.2% of patients. Regardless of the age class, the PPV was high for groups 1 to 3, ranging from 78.9% to 100%. The NPV was high in all groups, ranging from 68.8% to 99.1%. Conclusion: This study demonstrates that the triage implanted during the first COVID-19 lockdown was effective and is an appropriate tool for the referral of adults and children before clinical examination.

Date: 2023
Note: View the original document on HAL open archive server: https://hal.science/hal-04069273v1
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Published in PLoS ONE, 2023, 18 (2), pp.e0281390. ⟨10.1371/journal.pone.0281390⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04069273

DOI: 10.1371/journal.pone.0281390

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