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Emergency department visits related to functional abdominal pain in the pediatric age group
Chaitanya Pant1, Abhishek Deshpande2,3, Thomas J Sferra4
1Division of Gastroenterology, Hepatology and Motility, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
Insights
Pediatric emergency department visits for functional abdominal pain increased significantly between 2008 and 2012. However, hospital admissions from these visits decreased, with most children treated and released.
Area of Science:
- Pediatric Gastroenterology
- Public Health
- Health Services Research
Background:
- Functional abdominal pain (FAP) is a common reason for pediatric emergency department (ED) visits.
- Understanding trends in ED utilization for FAP is crucial for resource allocation and healthcare planning.
Purpose of the Study:
- To analyze trends in emergency department (ED) visits and hospital admissions for children with a primary diagnosis of functional abdominal pain (FAP).
Main Methods:
- Cross-sectional study utilizing data from the Nationwide Emergency Department Sample (HCUP-NEDS) from 2008 to 2012.
- FAP-related ED visits were identified using ICD-9-CM codes.
- Secondary diagnoses and admission factors were extracted and analyzed.
Main Results:
- In 2012, there were 796,665 pediatric ED visits for FAP, a rate of 11.5 per 1000 population.
- Both overall visits (+14.0%) and population-adjusted incidence (+16.0%) for FAP-related ED visits increased from 2008 to 2012.
- Hospital admissions from the ED decreased by 28.5% during the study period, with 96.7% of patients treated and released.
- Teaching hospital status was associated with a higher likelihood of admission (aOR 2.07).
- Nausea and/or emesis was the most frequent secondary diagnosis (19.8%).
Conclusions:
- Pediatric ED visits for FAP have significantly increased, indicating a growing burden on emergency services.
- Despite increased visits, hospital admission rates from the ED for FAP have declined, suggesting improved outpatient management or ED protocols.
- Further research into the drivers of increased FAP ED visits and strategies to reduce unnecessary admissions is warranted.
Abstract:
To analyze visits to and admissions from the emergency department (ED) in children with a primary diagnosis of functional abdominal pain (FAP). This was a cross-sectional study using data from the Nationwide Emergency Department Sample (HCUP-NEDS 2008-2012). FAP-related ED visits were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The most frequent secondary diagnoses associated with FAP-related ED visits were also extracted. In 2012, a total of 796,665 children presented to the ED with a primary diagnosis of FAP. This correlated to a rate of 11.5 ED visits/1000 population. The highest incidence of ED visits was observed for children in the 10-14-year age group; median (IQR) age of 11 (8) years. In analyzing the temporal trends associated with FAP-related ED visits, we observed an increase in both the overall number of visits (14.0%) as well as the population-adjusted incidence (16.0%) during the period 2008-2012. This coincided with a decreasing trend in hospital admissions from the ED; from 1.4% in 2008 to 1.0% in 2012 (-28.5%). The overwhelming majority (96.7%) of patients with FAP who presented to the ED were treated and released. On multivariate analysis, the leading factor associated with an increased likelihood of admission from the ED was teaching hospital status (aOR 2.07; 95% CI 1.97 to 2.18). The secondary diagnosis most commonly associated with FAP-related ED visits was nausea and/or emesis (19.8%). Pediatric FAP-related ED visits increased significantly from the period 2008 to 2012. However, the incidence of hospital admissions from the ED declined during the same period.
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