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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal neurologic emergencies requiring access to paediatric emergency units: a retrospective observational study
Raffaele Falsaperla1,2, Giovanna Vitaliti3, Monica Sciacca4
1Neonatal Intensive Care Unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", San Marco Hospital, University of Catania, Catania, Italy. raffaelefalsaperla@hotmail.com.
Insights
This study analyzed neonatal emergency visits for neurological conditions across three Italian hospitals. Cyanosis and apnea were the most common reasons for these urgent pediatric emergency unit visits.
Area of Science:
- Pediatric Emergency Medicine
- Neonatal Neurology
- Public Health
Background:
- Pediatric Emergency Units (PEUs) manage a wide range of childhood illnesses.
- Neonatal neurological conditions require specialized and timely assessment.
- Limited data exists on the specific patterns of neonatal neurological emergencies presenting to PEUs.
Purpose of the Study:
- To determine the incidence and characteristics of neonatal neurological emergencies in three Italian PEUs.
- To identify the most frequent neurological conditions leading to neonatal emergency visits.
- To analyze trends in neonatal neurological emergency access over a six-year period.
Main Methods:
- Retrospective, multi-center study of neonatal patients (within 28 days of life) admitted to three PEUs in Catania, Italy, from January 2015 to December 2020.
- Data collection included triage codes, clinical information, and discharge diagnoses for neurological conditions.
- Analysis focused on the proportion and types of neurological conditions among all neonatal emergency accesses.
Main Results:
- A total of 812, 3720, and 748 neonatal accesses were recorded in the three centers, with neurological conditions accounting for 8.4%, 3.7%, and 7.4% respectively.
- While overall pediatric accesses decreased, the proportion of neonatal neurological visits remained stable in one center.
- Cyanosis (46.1%) and apnea (29%) were the predominant neurological reasons for neonatal emergency unit visits.
Conclusions:
- Neonatal neurological emergencies, particularly cyanosis and apnea, represent a significant proportion of pediatric emergency unit visits.
- There is a need for enhanced training for healthcare professionals to accurately diagnose and manage these critical conditions.
- Further research is warranted to understand the long-term outcomes and optimal management strategies for neonatal neurological emergencies.
Abstract:
Herein, authors present a retrospective, multi-center study to determine the number of accesses to Pediatric Emergency Unit (PEU) of patients within 28 days of life, admitted to (1) the Acute and Emergency Pediatric Unit, San Marco University Hospital, Catania, Italy; (2) Garibaldi Hospital for Emergency Care, Catania, Italy; (3) Cannizzaro Hospital for Emergency Care, Catania, Italy. We included neonates admitted for neurologic problems, from January 2015 to December 2020, to the 1-Acute and Emergency Access of the San Marco University Hospital, Catania, Italy [observation center 1 (OC1)]; 2-Garibaldi Hospital for Emergency Care, Catania, Italy (Observation Center 2-OC2); 3-Cannizzaro Hospital for Emergency Care, Catania, Italy (Observation Center 3-OC3). For each patient, we evaluated the severity of urgency, by studying the admission triage-coloured codes, the clinical data at admission and the discharge diagnosis. Neonates who had access to PEU were 812 in the OC1, 3720 in the OC2, and 748 in the OC3 respectively; 69 (8.4%), 138 (3.7%), and 55 (7.4%) was the proportion of neonatal accesses for neurological conditions. We observed that in the study period, the three hospitals had an important decrease of pediatric accesses to their PEU, but the proportion of neonates who had access to the OC1 for neurologic diseases, with respect to the total neonatal accesses, remained stable. We found that the most frequent neurologic disease for which newborns had access to PEU was Cyanosis, (46.1% of all neonatal accesses). Apnea was the second most frequent cause, with a number of 76 accesses (29%). In the literature there are numerous studies on the assessment of diseases that most frequently concern the pediatric patient in an emergency room, but there are very few references on neonatal accesses for urgent neurologic diseases. Therefore, appropriate training is required to avoid unnecessary tests without overlooking potentially serious conditions.
