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Pediatría (Asunción)

On-line version ISSN 1683-9803

Abstract

LOPEZ, Valeria; PAVLICICH, Viviana; MORILLA, Laura  and  MESQUITA, Mirta. Analysis of repeat visits within 24 hours in a Pediatric Emergency Department during the epidemic period of respiratory infections. Pediatr. (Asunción) [online]. 2019, vol.46, n.1, pp.33-37. ISSN 1683-9803.  https://doi.org/10.31698/ped.46012019006.

Introduction:

Knowing the characteristics of repeat visits to an emergency service allows interventions to improve the quality of care. A repeat visit within 24 hours may imply an error in the assessment of the severity of the condition or user dissatisfaction regarding the result of the initial consultation. Objective: To characterize repeat visits within 24 hours in the Pediatric Emergency Department (PED) during an epidemic period.

Materials and methods:

This was an observational, retrospective, cross-sectional study. Patients aged 0 to 18 years were included, who had repeat visits within 24 hours in the PED of a pediatric referral hospital. The following were analyzed: age, sex, triage, place of origin, reason for consultation, diagnosis, hospitalization, interventions, complementary exams (laboratory and imaging), timing of repeat visit. The data were analyzed with SPSv21. The qualitative variables were expressed as percentages, the relationship between variables was performed using the Pearson chi-square test, the quantitative variables were expressed as averages with their standard deviations.

Results:

During the study period, 28,882 patients consulted, 4% (1,169) had repeat visits, all of which were included in the study. The median age was 24 months (2 - 204), and 59.4% came from areas outside the city of San Lorenzo, the hospital's reference area. The triage levels were mostly III and IV. The time between the first consultation and the repeat visit was 16 ± 6 hours, the most frequent diagnoses were respiratory diseases: obstructive bronchial syndrome (OBS) (14%), cold (13%), and bronchiolitis (13%). Interventions were carried out in 31.2% and complementary examinations in 17.4%. 13.3% (156/1169) of patients with repeat visits were hospitalized and required a higher number of interventions.

Conclusion:

Although a low priority triage level predominated among the repeat visits, there was a need to carry out interventions. A group of patients needed to be hospitalized. The epidemic of respiratory diseases ocurring during the study period could be a contributing factor.

Keywords : Pediatric emergencies; repeat visits; Hospitalization.

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