Short Term Unscheduled Revisits to  Paediatric Emergency Department - A  Six Year Data

Kılıçaslan, Önder; Sönmez, Feruza Turan; Gunes, Harun; Temizkan, Ramazan Cahit; Kocabay, Kenan; Sarıtaş, Ayhan

doi:10.7860/jcdr/2017/25098.9484

Cited by 5 publications

(6 citation statements)

References 20 publications

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“…Similar to other studies [ 15 , 28 , 29 ], most patients with URVs in our study were male and of young age. Toddlers and young children (younger than 3 years) tend to have frequent PEC visits and are associated with URVs [ 9 , 15 , 30 ]. Young children have poor communication ability, which makes it difficult to effectively report their symptoms and disease severity.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, waiting time and length of stay are increased [ 3 ], and emergency care delivery [ 4 ] and the overall quality of care [ 5 ] are impacted. However, unscheduled patient revisits to the EC could also highlight deficiencies in the initial patient assessment, treatment or intervention [ [6] , [7] , [8] ], and reveal inadequacies in hospital systems or healthcare providers [ 9 ]. Unscheduled return visits (URV) could be attributable to disease-related factors, including the natural progression of the disease [ 10 ], advance to acute and chronic illnesses [ 11 ] and the use of assistive devices [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and outcomes of patients with an unscheduled return visit within 72 hours to the Paediatric Emergency Centre at a Private Tertiary Referral Hospital in Kenya

Rintaari

Kimani

Musembi

et al. 2021

African Journal of Emergency Medicine

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Introduction Patients’ unscheduled return visits (URVs) to the paediatric emergency Centre (PEC) contribute to overcrowding and affect health service delivery and overall quality of care. This study assessed the characteristics and outcomes of paediatric patients with URVs (within 72 hours) to the PEC at a private tertiary hospital in Kenya. Methods We conducted a retrospective chart review of all URVs within 72 hours among paediatric patients aged ≤15 years between 1 July and 31 December 2018 at the tertiary hospital in Nairobi, Kenya. Results During the study period, 1.6% ( n =172) of patients who visited the PEC returned within 72 hours, with 4.7% revisiting the PEC more than once. Patients’ median age was 36 months (interquartile range: 42 months); over half were male (51.7%), 55.8% were ambulatory and 84.3% were insured. In addition, 21% ( n =36) had chronic diseases and 7% ( n =12) had drug allergies. Respiratory (59.5%) and gastrointestinal (21.5%) tract infections were the most common diagnoses. Compared with the first visit, more patients with URVs were classified as urgent (1.7% vs. 5.2%) and were non-ambulatory (44.2% vs. 49.5%, p =<0.001); 18% of these patients were admitted. Of these 58% were male, 83.9% were aged 0–5 years, 12.9% were classified as urgent, 64.5% had respiratory tract infections and 16.1% had gastrointestinal tract infections. Being admitted was associated with patient acuity ( p =0.004), laboratory tests ( p =<0.001) and ambulatory status ( p =0.041). Conclusion The URV rate is low in our setting. Patients who returned to the PEC within 72 hours tended to be male, under 5 years old and insured. Many were non-urgent cases with diagnoses of respiratory and gastrointestinal tract infections. The findings suggest that some URVs were necessary and may have contributed to better care and improved outcomes while others highlight a need for effective patient education and comprehensive initial assessment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics and outcomes of patients with an unscheduled return visit within 72 hours to the Paediatric Emergency Centre at a Private Tertiary Referral Hospital in Kenya

Rintaari

Kimani

Musembi

et al. 2021

African Journal of Emergency Medicine

View full text Add to dashboard Cite

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“…Another reason is that HRCT, which is used as the gold standard investigation for evaluating lung parenchymal involvement, may be used due to the fact that it is not so sensitive in demonstrating parenchymal involvement. [34] Mostard et al [35] reported that PET-CT was superior to HRCT in demonstrating inflammatory activity in parenchymal areas in patients with sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

Is lymphopenia detected in sarcoidosis is associated with the disease activity?

Doğan¹

2019

South Clin Ist Euras

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The association of lymphopenia detected in patients with sarcoidosis with disease activity was investigated in the present study. Methods: Patients who were diagnosed as having sarcoidosis and healthy volunteers/individuals with no diagnosis of active disease between July 2016 and June 2017 were included in this study. Patients who were detected to have an absolute lymphocyte count (ALC) of <1.3 × 10³/mm³ were accepted as lymphopenic patients. The detection rates of lymphopenia were compared between two groups. The respiratory function testing-diffusing capacity of the lungs for carbon monoxide (RFT-DLCO) levels and the high-resolution computed tomography (HRCT) results of patients with and without lymphopenia in the sarcoidosis group were compared. Results: In the sarcoidosis group, 77 patients were included, and in the control group, 41 patients were included. The number of lymphopenic patients in the sarcoidosis group was 21 (27.2%), and that in the control group was 1 (2.4%) (p=0.001). The percentaged DLCO value of 33 patients (28%) was below 80%; however, the percentaged DLCO value of 44 patients was higher than 80% in the sarcoidosis group. The mean ALC of patients in the sarcoidosis group who had a DLCO value of <80% was 1.6±0.7; however, the mean ALC of patients who had a DLCO value of >80% was 2±0.7 (p=0.016). A positive correlation was detected between ALC and DLCO% (p=0.044, r=0.230). Although lymphopenia was detected in 42% of patients whose DLCO value was <80%, lymphopenia was detected in 15% of patients whose DLCO value was >80% (p=0.01). No significant association was detected among the sarcoidosis stage, symptom, and radiologic findings of the patients with the absolute lymphocyte count (p>0.05). Conclusion: Lymphopenia is frequently detected in patients with sarcoidosis. Lower DLCO values may be detected in patients with lymphopenic sarcoidosis.

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“…A few studies on ED revisits were conducted on pediatric patients. In previous studies, the ED revisit rates of pediatric patients varied from 2.2% to 8.0% [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], and the number of pediatric revisits to EDs was reported to increase each year [ 19 ]. The ED revisit rates were high among infants, toddlers [ 9 , 12 , 14 , 17 , 18 , 19 ], and children with chronic diseases [ 11 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Emergency Department Revisit Rates of Pediatric Patients between Pre-COVID-19 and COVID-19 Periods

et al. 2022

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Unscheduled revisits to emergency departments (EDs) are important because they indicate the quality of emergency care. However, the characteristics of pediatric patients visiting EDs changed during the coronavirus disease (COVID-19) pandemic, and these changes may have affected their revisit patterns. Therefore, we aimed to compare the ED revisit patterns of pediatric patients between the pre-COVID-19 and COVID-19 periods. This retrospective multicenter study included patients aged below 18 years who visited the ED in the pre-COVID-19 and COVID-19 periods. ED revisit rates were analyzed using five age groups and three visit-revisit intervals. In the pre-COVID-19 period, the revisit rates decreased with increasing age. In the COVID-19 period, the revisit rates were the lowest for the group aged 4–6 years, and the rates increased for those aged ≥7 years. In conclusion, there were changes in the patterns of revisit rates of pediatric patients according to age between the pre-COVID-19 and COVID-19 periods. Therefore, it is necessary to identify the reasons for revisits according to age and establish strategies to reduce the revisit rates of pediatric patients.

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Short Term Unscheduled Revisits to Paediatric Emergency Department - A Six Year Data

Cited by 5 publications

References 20 publications

Characteristics and outcomes of patients with an unscheduled return visit within 72 hours to the Paediatric Emergency Centre at a Private Tertiary Referral Hospital in Kenya

Characteristics and outcomes of patients with an unscheduled return visit within 72 hours to the Paediatric Emergency Centre at a Private Tertiary Referral Hospital in Kenya

Is lymphopenia detected in sarcoidosis is associated with the disease activity?

A Comparison of Emergency Department Revisit Rates of Pediatric Patients between Pre-COVID-19 and COVID-19 Periods

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