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Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia

Authors :
Mohammed A. Al Ghamdi
Reem S AlOmar
Sameerah Motabgani
Naheel A AlAmer
Bassam H. Awary
Roaya A. AlQunais
Malak Al Shammari
Haneen A. Yousef
Fatimah Y. Altaweel
Fatima A. Alsubaie
Mohammad H. Al-Qahtani
Kawthar M. Alsawad
Waleed H. Albuali
Kawther S. Altaweel
Abdullah A Yousef
Nouf A AlShamlan
Source :
BMC Emergency Medicine, BMC Emergency Medicine, Vol 21, Iss 1, Pp 1-8 (2021)
Publication Year :
2021
Publisher :
Springer Science and Business Media LLC, 2021.

Abstract

Background The Emergency Room (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia. Methods This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome. Results The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57–5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85–89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65–51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70–133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23–0.38). Conclusions A low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.

Details

ISSN :
1471227X
Volume :
21
Database :
OpenAIRE
Journal :
BMC Emergency Medicine
Accession number :
edsair.doi.dedup.....4e92ded78d7ef4ff2344dab2f9f5acf9
Full Text :
https://doi.org/10.1186/s12873-021-00467-7