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Emergency department risk factors for serious clinical deterioration in a paediatric hospital in Peru.
Nielsen, Katie R; Aronés Rojas, Rubén; Tantaleán da Fieno, José; Huicho, Luis; Roberts, Joan S; Zunt, Joseph.
Afiliação
  • Nielsen KR; Department of Pediatrics Critical Care Medicine, University of Washington, Seattle, Washington, United States.
  • Aronés Rojas R; Department of Global Health, University of Washington, Seattle, Washington, United States.
  • Tantaleán da Fieno J; Departments of Emergency, National Institute of Child Health, Lima, Peru.
  • Huicho L; Departments of Critical Care, National Institute of Child Health, Lima, Peru.
  • Roberts JS; National University Federico Villareal, Lima, Peru.
  • Zunt J; Research Center for Maternal and Child Health, Research Center for Integral and Sustainable Development, Cayetano Heredia University, Lima, Peru.
J Paediatr Child Health ; 54(8): 866-871, 2018 08.
Article em En | MEDLINE | ID: mdl-29582497
AIM: Identification of critically ill children upon presentation to the emergency department (ED) is challenging, especially when resources are limited. The objective of this study was to identify ED risk factors associated with serious clinical deterioration (SCD) during hospitalisation in a resource-limited setting. METHODS: A retrospective case-control study of children less than 18 years of age presenting to the ED in a large, freestanding children's hospital in Peru was performed. Cases had SCD during the first 7 days of hospitalisation whereas controls did not. Information collected during initial ED evaluation was used to identify risk factors for SCD. RESULTS: A total of 120 cases and 974 controls were included. In univariate analysis, young age, residence outside Lima, evaluation at another facility prior to ED presentation, congenital malformations, abnormal neurologic baseline, co-morbidities and a prior paediatric intensive care unit admission were associated with SCD. In multivariate analysis, age < 12 months, residence outside Lima and evaluation at another facility prior to ED presentation remained associated with SCD. In addition, comatose neurological status, hypoxaemia, tachycardia, tachypnoea and temperature were also associated with SCD. CONCLUSIONS: Many risk factors for SCD during hospitalisation can be identified upon presentation to the ED. Using these factors to adjust monitoring during and after the ED stay has the potential to decrease SCD events. Further studies are needed to determine whether this holds true in other resource-limited settings.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Equipe de Assistência ao Paciente / Serviço Hospitalar de Emergência / Deterioração Clínica / Hospitais Pediátricos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America do sul / Peru Idioma: En Revista: J Paediatr Child Health Assunto da revista: PEDIATRIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Austrália
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Equipe de Assistência ao Paciente / Serviço Hospitalar de Emergência / Deterioração Clínica / Hospitais Pediátricos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America do sul / Peru Idioma: En Revista: J Paediatr Child Health Assunto da revista: PEDIATRIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Austrália