Pediatric outpatient consultation at the Emergency Department of a University Hospital

Abstract

Introduction: To determine the epidemiological profile of pediatric consultations treated at the emergency department (ED) is essential for planning processes of medical care and to guide education programs and research. 

Objectives: To describe the characteristics of the child population and the main reasons for consultation (RFC) seen in a pediatric emergency service. 

Patients and Method: A retrospective, descriptive clinical study was conducted regarding the visits to the Children's Emergency Service of an academic hospital in Santiago, for a period of twelve months. RFC were analyzed by age group, severity, seasonality, disposition and frequency of recurrent visits. 

Results: 24,531 pediatric consultations were evaluated, 51.9% were male (n = 12,720). The age of the patients ranged between one day old and 15 years, with a median age of 36.5 months. 1.5% of patients were newborns (NB), 17.6% were infants (n = 4,326), 51.9% were preschoolers (n = 12,725) and 29% were school children (n = 7,118). Major RFC were fever (n = 6,643, 28.2%), gastrointestinal symptoms (n = 5,606, 23.8%) and respiratory symptoms (n = 5,018, 21.3%), which did not differ significantly according to gender. Most patients (95.5%) were sent to their homes. The risk of hospitalization was more elevated in NB and in those with jaundice (OR = 7.20, 95% CI 3.12 to 16.6), neurological symptoms (OR = 6.90, 95% CI 4.60 -10.4) and poisoning (OR = 6.45, 95% CI 2.82 to 14.7). About 4% were repeat visits, especially in the NB group. 

Conclusions: The epidemiological profile of pediatric consultations seen at the ED was similar to that described in previous studies. However, a lower rate of hospitalization was found even though the patients had similar risk profile.