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Seventy-Two-Hour Emergency Department Revisits in the Pediatric Population at King Abdullah Specialist Children's
Mohammed AlAteeq1,2, Shaden Althuwaini2,3, Haya Alsubaie2,3
1Ambulatory Care Services, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia, ngha.med.sa.
Insights
Pediatric emergency department revisits are increasing globally. Persistent respiratory symptoms, particularly cough, are the main reason for these revisits in children, highlighting the need for improved initial diagnosis and management.
Area of Science:
- Pediatrics
- Emergency Medicine
- Respiratory Medicine
Background:
- Global increase in pediatric emergency department (ED) revisits within 72 hours noted.
- Respiratory illness surges potentially strain healthcare resources.
- Study focuses on children aged 0-14 years.
Purpose of the Study:
- Identify reasons for pediatric ED revisits within 72 hours.
- Describe management outcomes for children who revisit the ED.
- Inform strategies to reduce avoidable pediatric ED revisits.
Main Methods:
- Cross-sectional chart review conducted at a tertiary hospital.
- Included Saudi children aged 0-14 years with ED revisits within 72 hours.
- Captured demographics, medical history, and visit details.
Main Results:
- 300 children included; 31% aged 0-3 years, 60% male.
- 26% had chronic conditions; asthma exacerbation most common (12%).
- Persistent cough (34%) was the most frequent revisit reason; similar antibiotic prescription rates at initial and revisit visits.
Conclusions:
- Persistent respiratory symptoms (cough, dyspnea) are primary drivers of pediatric ED revisits.
- Asthma identified as the most common chronic condition associated with revisits.
- Enhanced initial diagnosis and management are crucial for reducing revisits.
Background:
Recent data suggest that pediatric emergency department (ED) revisits within 72 h have increased globally, particularly during recent respiratory illness surges, potentially straining healthcare resources. This study is aimed at identifying reasons for these revisits and describe management outcomes for children aged 0-14 years.
Methods:
A cross-sectional chart review was conducted at a tertiary hospital in Riyadh from March 1, 2022, to April 30, 2023. The study included Saudi nationals aged 0-14 years who revisited the ED within 72 h of their initial visit; noncitizen children were excluded. Data captured included demographics, medical history, and details of both initial and revisits (reason for visit, assessment, and management).
Results:
Three hundred Saudi children were included; 31% were aged 0-3 years, and approximately 60% were male. Twenty-six percent had chronic medical conditions, with asthma exacerbation being most common (12%). Persistent cough accounted for the highest proportion of revisits (34%). Antibiotics were prescribed in 28% of initial visits and 29% of revisits. Reassurance was provided in 27% of initial visits and 27% of revisits. The 0-3 year age group showed significantly higher rates of admission and discharge.
Conclusion:
Persistent respiratory symptoms (especially cough and dyspnea) were the most frequent reasons for pediatric ED revisits, with asthma as the prevalent chronic condition. Improving initial diagnosis and management is essential to reduce avoidable revisits. Future research comparing presurge and postsurge periods could clarify if revisit reasons change over time.
