Characteristics of Febrile Children Admitted to the ICU Following an Unscheduled ED Revisit Within 72 h, a Case-Control Study

doi:10.3389/fped.2020.00411

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24660

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/24660

Title:	Characteristics of Febrile Children Admitted to the ICU Following an Unscheduled ED Revisit Within 72 h, a Case-Control Study
Authors:	Chiang, CY;Chen, YL;Lin, YR;Cheng, FJ;Wu, KH;Chiu, IM
Keywords:	fever;children;intensive care unit admission;emergency department;unscheduled revisit
Date:	2020
Issue Date:	2022-08-09T08:05:57Z (UTC)
Publisher:	FRONTIERS MEDIA SA
ISSN:	2296-2360
Abstract:	Objective:The purpose of this article was to demonstrate related characteristics of intensive care unit (ICU) admission after an unscheduled revisit by febrile children visiting the emergency department (ED). Method:We performed a retrospective study in a tertiary medical center from 2010 to 2016. Patients whose chief complaint was fever and who were admitted to the ICU following a 72-h return visit to the ED were included, and we selected patients who were discharged from the same emergency department for comparison. Results:During the study period, 54 (0.03%) patients met the inclusion criteria, and 216 patients were selected for the matched control group. Regarding clinical variables on initial ED visit, visiting during the night shift (66.7 vs. 46.8%,p= 0.010), shorter length of 1st ED stay (2.5 +/- 2.63 vs. 3.5 +/- 3.44 h,p= 0.017), and higher shock index (SI) (1.6 +/- 0.07 vs. 1.4 +/- 0.02,p= 0.008) were associated with ICU admission following a return visit. On the return ED visit, we found that clinical variables such as elevated heart rate, SI, white blood cell count, and C-reactive protein level were all associated with ICU admission. Furthermore, elevated SI and pediatric age-adjusted (SIPA) values were observed in the study group in both the initial (42.2 vs. 20.1%, OR:2.3 (1.37-4.31),p= 0.002) and return ED visits (29.7 vs. 6.9%, OR: 4.6 (2.42-8.26),p< 0.001). Conclusion:For children who visited the emergency department with a febrile complaint, elevated SIPA values on the initial ED visit were associated with ICU admission following an unscheduled ED revisit within 72 h.
URI:	http://dx.doi.org/10.3389/fped.2020.00411 https://www.webofscience.com/wos/woscc/full-record/WOS:000563197100001 https://ir.csmu.edu.tw:8080/handle/310902500/24660
Relation:	FRONTIERS IN PEDIATRICS ,2020 ,v8
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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