The Clinical Differences between Urgent Visits and Non-Urgent Visits in Emergency Department During the Neonatal Period.
10.3346/jkms.2017.32.11.1870
- Author:
Hyung Jun YANG
1
;
Woochan JEON
;
Hee Jung YANG
;
Jae Ryoung KWAK
;
Hyo Yeon SEO
;
Ji Sook LEE
Author Information
1. Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea. eesysook@naver.com
- Publication Type:Original Article
- Keywords:
Neonate;
Emergency Department;
Urgent;
Non-urgent
- MeSH:
Cough;
Emergencies*;
Emergency Service, Hospital*;
Fever;
Humans;
Infant, Newborn;
Jaundice;
Length of Stay;
Logistic Models;
Medical Records;
Retrospective Studies;
Thorax;
Vomiting
- From:Journal of Korean Medical Science
2017;32(11):1870-1875
- CountryRepublic of Korea
- Language:English
-
Abstract:
As neonates are brought to the emergency department (ED) for various complaints, it is challenging for emergency physicians to clinically determine the urgency of the visit. We sought to explore clinical characteristics associated with urgent visits to the ED. We conducted a retrospective study by reviewing medical records of neonatal visits to a tertiary pediatric regional emergency center for 5 years. Cases of patients who were discharged after checking only chest or abdominal X-ray or discharged without workup, were classified as non-urgent visits. Cases where more examinations were performed, or when the patient was hospitalized, were classified as urgent visits. Various clinical features and process in the ED were compared between the groups. Of the 1,008 cases enrolled in this study, 856 (84.9%) were urgent and 152 (15.1%) were non-urgent visits. After adjustment by multiple logistic regression analysis, non-urgent visits were associated with self-referrals rather than physician-referrals (odds ratio [OR], 5.96), visits in the evening rather than at night or daytime (OR, 2.51), patient visits from home rather than from medical facilities (OR, 2.19; 95). Fever and jaundice were the most common complaints (25.7% and 24.5%, respectively), and their OR of non-urgent visit was relatively low (adjusted OR 0.03 and 0.03, respectively). However, other common complaints, such as vomiting and cough (7.4% and 7.1%, respectively), were more likely to be non-urgent visits (adjusted OR 2.96 and 9.83, respectively). For suspected non-urgent visits, emergency physicians need to try to reduce unnecessary workup and shorten length of stay in ED.
