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Community-Acquired Pneumonia Diagnosis Following Emergency Department Visits for Respiratory Illness
Alexandra T Geanacopoulos1,2, Janine P Amirault1,2, Kenneth A Michelson3
1Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Insights
Community-acquired pneumonia (CAP) is rare in children after an emergency department visit for respiratory illness. Fever during the initial visit increased the odds of a CAP diagnosis within seven days.
Area of Science:
- Pediatrics
- Infectious Diseases
- Emergency Medicine
Background:
- Community-acquired pneumonia (CAP) is a common consideration for pediatric patients presenting with respiratory symptoms to the emergency department (ED).
- The actual incidence of CAP diagnosis following an ED visit for respiratory illness in children remains unclear.
Purpose of the Study:
- To determine the frequency of 7-day CAP diagnoses in children discharged from the ED with respiratory illness.
- To identify predictors associated with a 7-day CAP diagnosis after an ED visit.
Main Methods:
- A retrospective case-control study was conducted.
- Data included children aged 3 months to 18 years discharged from the ED with respiratory illness between 2011 and 2021.
- Logistic regression analysis was used to identify predictors of 7-day CAP diagnosis.
Main Results:
- Out of 10,329 children, 74 (0.7%) were diagnosed with CAP within 7 days of discharge.
- Fever at the initial ED visit was significantly associated with an increased odds of CAP diagnosis (OR = 3.32).
Conclusions:
- Diagnosing community-acquired pneumonia after emergency department discharge for respiratory illness is infrequent in children.
- Fever is a key predictor, but CAP remains uncommon even in febrile children evaluated in the ED.
Abstract:
Community-acquired pneumonia (CAP) is often considered for children presenting to the emergency department (ED) with respiratory symptoms. It is unclear how often children are diagnosed with CAP following an ED visit for respiratory illness. We performed a retrospective case-control study to evaluate 7-day CAP diagnosis among children 3 months to 18 years discharged from the ED with respiratory illness from 2011 to 2021 and who receive care at 4 hospital-affiliated primary care clinics. Logistic regression was performed to assess for predictors of 7-day CAP diagnosis. Seventy-four (0.7%, 95% confidence interval [CI] = 0.6%, 0.9%) of 10 329 children were diagnosed with CAP within 7 days, and fever at the index visit was associated with increased odds of diagnosis (odds ratio [OR] = 3.32, 95% CI = 1.75-6.28). Community-acquired pneumonia diagnosis after discharge from the ED with respiratory illness is rare, even among children who are febrile at time of initial evaluation.
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