Patterns of paediatric emergency admissions and predictors of prolonged hospital stay at the children emergency room, University of Calabar Teaching Hospital, Calabar, Nigeria

Abstract

BackgroundThere is a high prevalence of paediatric emergency cases in less developed countries. However, prolonged hospital stay at emergency units may further overstretch the facilities.ObjectiveTo assess the patterns of presentations, services offered and predictors of a prolonged stay at the Children Emergency Room of a tertiary hospital in Southern Nigeria.MethodsThis prospective cross-sectional, study was conducted at the University of Calabar Teaching Hospital, Nigeria from 1st January–31st December 2014. Socio-demographic and clinical characteristics of consecutively recruited children (n=633) were recorded in a proforma. Binary logistic regression was conducted to determine predictors of prolonged stay (>72 hours)ResultThe median age of participants was 2 (1 – 4.6) years. Three-fifths of children were admitted at off-hours and the commonest symptom was fever (73.9%). About 16.4% (95%CI:13.6% – 19.4%, n= 103/633) of the children had prolonged stay while those with sepsis had the longest mean stay (65.5±72.1 hours). Children admitted on account of Sickle cell disease (OR:11.2, 95%CI:1.3–95.1, P-value = 0.03), Malaria (OR:10.7, 95%CI:1.4–82.5, P-value = 0.02) or sepsis (OR:10.5, 95%CI:1.3 – 82.7, P-value = 0.03) had higher odds of prolonged hospital stay. There was no significant difference in hospital stay among children admitted by the consultant as compared to other health personnel (P-value = 0.08).ConclusionPrevention and proper management of Sickle cell disease and malaria reduces paediatric hospital stay in our environment. Paediatric emergency medicine should be re-organized to cater for high volume of off-hour admissions.

Epidemiological Profile of Pediatric Vital Emergencies at Laquintinie Hospital of Douala, Cameroon

“…In our series, the pediatric emergency unit received patients until their stabilization. The average length of stay in the pediatric emergency room was 2.7 days (min-max: 1 -44 days), Enyuma et al reported a similar trend in their study in Nigeria [12]. In our series, the intensive care unit received patients until their stabilization.…”

“…This result was similar to those found byNzame et al in Gabon, Ly Fatou in Senegal in 2016 and Asse et al, in Ivory Coast (2012). This was unlike results by Enyuma et al in Nigeria (2014) which had found a female predominance [8] [10] [11][12]. The mean age of the patients was 3.80 years, and children under 5 years of age accounted for 80.7% of patients.…”

“…Enyuma et al and Fatou Ly et al where life-threatening emergencies were mostly received during on-call hours[10] [12]. The most frequent reasons for consultation were seizures, dyspnea and fever.…”

Aplicação e contribuições dos indicadores hospitalares: uma revisão integrativa

“…Além disso, um estudo ecológico que utilizou dados secundários dos SIH do território nacional evidenciou elevadas taxas de internação por lesões decorrentes de acidentes de transporte terrestre com predominância de pessoas do sexo masculino, residentes das regiões Centro-Oeste e Nordeste, com prevalência de jovens adultos, verificaram-se ainda que existe a possibilidade de homens terem maiores taxas de internações, pois se expõe mais a situações de risco por questões culturais (Andrade & Jorge, 2017). Na cidade de Calabar, Nigéria, um estudo avaliou os padrões de internamento hospitalar bem como o tempo de permanência em crianças admitidas no setor de emergência infantil em um hospital universitário da cidade de Calabar, e mostrou que houve uma proporcionalidade assimétrica quanto à idade, ou seja, crianças menores apresentavam tempo de permanência maior, evidenciando a média do tempo de permanência nesse hospital de 48 Development, v. 9, n. 8, e902986637, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i8.6637 horas, outro ponto relevante dessa pesquisa foi que o maior tempo de estadia estava relacionado a doenças infecciosas e que procedimentos cirúrgicos demandavam menor tempo de permanência hospitalar (Enyuma et al, 2019).…”

Maternal, adolescent and child health issues in low and middle income countries: towards achieving the sustainable development goals

“…About a quarter of the admissions were due to fever, sickle cell anaemia and sepsis. The two later conditions were associated with prolonged hospital stay 11. Common causes of morbidity such as fever contributed the highest percentage of admissions.…”