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Factors Associated with Unscheduled Emergency Department Revisits in Children with Acute Lower Respiratory Tract

Teeranai Sakulchit1, Suphakorn Thepbamrung1

  • 1Department of Emergency Medicine, Songklanagarind Hospital, Prince of Songkla University, Hatyai, Songkhla, Thailand.

Open Access Emergency Medicine : OAEM
|June 28, 2022
PubMed

Insights

Children with asthma experiencing acute lower respiratory tract diseases are at higher risk for emergency department revisits. Not prescribing systemic corticosteroids during the emergency department visit increases this risk.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Emergency Medicine

Background:

  • Acute lower respiratory tract diseases are common causes of pediatric emergency department visits.
  • Unscheduled revisits to the emergency department within 72 hours can indicate suboptimal initial management or disease severity.

Purpose of the Study:

  • To identify factors associated with unscheduled emergency department (ED) revisits within 72 hours in children with acute dyspnea from lower respiratory tract diseases.

Main Methods:

  • Retrospective cohort study of pediatric patients (1 month to 15 years) with acute lower respiratory tract diseases.
  • Analysis of medical records to compare characteristics, vital signs, diagnoses, treatments, and length of stay between patients who revisited the ED and those who did not.
  • Logistic regression used to determine significant factors associated with revisits.

Main Results:

  • A history of asthma or current controller medication use was significantly associated with revisits (OR: 3.08).
  • Failure to prescribe systemic corticosteroids in the ED or prescribing them only upon discharge was significantly linked to revisits (P < 0.001 and P = 0.022, respectively).

Conclusions:

  • In children with acute lower respiratory tract diseases and a history of asthma, the absence of systemic corticosteroid administration in the ED is associated with increased 72-hour revisits.
  • Optimizing corticosteroid management in the ED for pediatric patients with asthma and lower respiratory tract disease may reduce unscheduled revisits.
Abstract

Keywords:
childdyspneaemergency departmentrespiratory system abnormalitiesrevisit

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