Epidemiology of Hyperbilirubinemia in a Quaternary Pediatric Emergency Department over a Three-Year Period.
10.5223/pghn.2018.21.4.297
- Author:
Zebulon TIMMONS
1
;
Jaci TIMMONS
;
Christina CONRAD
;
Tamir MILOH
Author Information
1. Division of Emergency Medicine, Phoenix Children's Hospital, Phoenix, AZ, United States. ztimmons@phoenixchildrens.com
- Publication Type:Original Article
- Keywords:
Hyperbilirubinemia;
Pediatrics;
Emergency medicine
- MeSH:
Bilirubin;
Cohort Studies;
Dataset;
Diagnosis;
Emergencies*;
Emergency Medicine;
Emergency Service, Hospital*;
Epidemiology*;
Hospitalization;
Humans;
Hyperbilirubinemia*;
Incidence;
Liver;
Male;
Mortality;
Pediatrics;
Prognosis;
Retrospective Studies
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2018;21(4):297-305
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: There is a lack of scholarly reports on pediatric emergency department (PED) exposure to hyperbilirubinemia. We aimed to describe the epidemiology of hyperbilirubinemia in patients presenting to a PED over a three-year period. METHODS: This was a retrospective cohort study, completed at an urban quaternary academic PED. Patients were included if they presented to the PED from 2010 to 2012, were 0 to 18 years in age, and had an elevated serum bilirubin for age. A chart review was completed to determine the incidence of hyperbilirubinemia, etiology, diagnostic work up and prognosis. The data set was stratified into four age ranges. RESULTS: We identified 1,534 visits where a patient was found to have hyperbilirubinemia (0.8% of all visits). In 47.7% of patients hyperbilirubinemia was determined to have arisen from an identifiable pathologic etiology (0.38% of all visits). First-time diagnosis of pathologic hyperbilirubinemia occurred in 14% of hyperbilirubinemia visits (0.11% of all visits). There were varying etiologies of hyperbilirubinemia across age groups but a male predominance in all (55.0%). 15 patients went on to have a liver transplant and 20 patients died. First-time pathologic hyperbilirubinemia patients had a mortality rate of 0.95% for their initial hospitalization. CONCLUSION: Hyperbilirubinemia was not a common presentation to the PED and a minority of cases were pathologic in etiology. The etiologies of hyperbilirubinemia varied across each of our study age groups. A new discovery of pathologic hyperbilirubinemia and progression to liver transplant or death during the initial presentation was extremely rare.
