Emergency department presentations of febrile children to an Australian public hospital

Emergency department presentations of febrile children to an Australian public hospital

Aim We investigated the presentations of children with unspecified fever to an Australian emergency department (ED): (i) to determine the proportion of these presentations that could be classified as potentially avoidable and (ii) to identify factors associated with an increased risk of hospital adm...

Full description

Saved in:
Bibliographic Details
Published in:Journal of paediatrics and child health Vol. 54; no. 12; pp. 1308 - 1313
Main Authors: Bereznicki, Bonnie J, Tucker, Madeline GA, Beggs, Sean A, Zosky, Graeme R, Bereznicki, Luke RE
Format: Journal Article
Language:English
Published: Australia John Wiley & Sons Australia, Ltd 01-12-2018
Blackwell Publishing Ltd
Subjects:
Child, Preschool
emergency department child fever
Emergency medical care
emergency medicine
Emergency Service, Hospital
Female
Fever
Fever - epidemiology
Hospitalization - trends
Hospitals, Public
Humans
Infant
Logistic Models
Male
Medical Audit
Medical diagnosis
Pediatrics
Quantitative analysis
Retrospective Studies
Tasmania - epidemiology
Tasmania
Australia
emergency medicine
fever
emergency department child fever
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aim We investigated the presentations of children with unspecified fever to an Australian emergency department (ED): (i) to determine the proportion of these presentations that could be classified as potentially avoidable and (ii) to identify factors associated with an increased risk of hospital admission. Methods This study retrospectively identified and described children aged <6 years who presented to the Royal Hobart Hospital (Tasmania, Australia) ED with unspecified fever (ICD‐10‐AM code R50.9) between January 2013 and December 2015, using data from the ED information system and digital medical records. The Australian Institute of Health and Welfare method was used to estimate the number of potentially avoidable general practitioner‐type presentations. Predictors of hospital admission were determined using multivariate logistic regression. Results A total of 459 patients aged <6 years presented to the ED with a primary diagnosis description of unspecified fever. Of these, 30.7% were classed as potentially avoidable general practitioner‐type presentations. Overall, 26.1% of presentations resulted in admission to hospital. Administration of intravenous fluids in the ED and a longer treat time were identified as significant predictors of a child with non‐specific fever being admitted to hospital. Older age, administration of antipyretics in the ED and presentations triaged as semi‐urgent and non‐urgent significantly reduced the probability of admission. Conclusions To our knowledge, this is the first Australian study that has assessed the impact of unspecified childhood fever on an Australian ED. Further investigation of presentations classified as potentially avoidable is warranted to investigate whether these could be managed in the primary care setting.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1034-4810
1440-1754
DOI:10.1111/jpc.14071