Profile of patients visiting the pediatric emergency service in El-Behera Hospitals

Abstract

Background The emergency department (ED) is an essential component of the medical service offered in any hospital. However, the published information about patients' profile and utilization of emergency services in both developing and developed countries is scarce. Visits caused by nonserious diseases remain a burden on the ED, preventing efficient and effective use of health services and compromising quality. Aim This study aimed to characterize the profile of patients visiting the emergency service in El-Behera Hospitals (Damanhour Teaching Hospital, Central Abohommos Hospital, and General Kafr Eldawar Hospital), describing the epidemiology of patient presentations and outcome in the ED. Patients and methods This is a descriptive study reporting the profile of patients visiting the ED for three months from January to March 2019. The EDs served children up to the age of 18 years. A junior physician first examines patients on a 24-h basis. The ED offered diagnostic services in the form of basic laboratory tests and imaging as well as brief therapeutic measures. The data were collected from the ED sheet initiated by the first examiner and completed by the ED senior. Forms were first checked for adequacy and completeness. The data included the following: demographic characteristics such as age/sex and season. Clinical history included symptoms/diagnosis and outcome within the first 24 h of presentation. Patients with previously diagnosed chronic conditions were noted. The outcomes, including discharge from the ED, whether discharge on treatment or follow-up, referral, hospital admission, or mortality, were also noted. Our cases were collected by visiting the ED for 2 h in the morning, 2 h in the evening, and 2 h at night. Every visit was once per week for three months in the three study hospitals. During the time of the visit, the investigator was able to examine most children coming for health service. Only those who were missed were in circumstances when the frequency of patient visits was overwhelming. Results The total number of registered ED visits during the study period (3 months) at El-Behera Hospitals (Damanhour Teaching Hospital, Central Abohommos Hospital, and General Kafr Eldawar Hospital) was 130 500 patients; the number of registered pediatric ED visits during this period was 29 340 (22.5%) patients. The sample of our study represented 600 patients by collecting random sample through regular visits to ED. Infants (1 month to 1 year) represented the largest age group (52.5%), and boys represented the majority of cases (51.5%). The main presentation was cough (25%) and respiratory distress (21%), followed by fever (15.5%), diarrhea (11%), wheezy chest (11.5%), and then convulsion (4%). Long-term illnesses were predominantly bronchial asthma (9%), hemolytic anemia (1%), congenital heart disease (0.5%), down syndrome (0.5%), and failure to thrive (0.5%). The overall mortality rate was 0. Conclusion Infants younger than 1 year are the largest group attending ED, representing 315 (52.5%) cases. Respiratory emergencies are the leading cause of attending ED, representing 390 (65%) cases. Rural attendees are more than urban [375 (62.5%) vs 225 (37.5%)]. Chronic disorder is one of the causes of attending ED. The rate of hospitalization is low at 72 (12%) cases. The case fatality rate is 0%. Most patients attended ED in the evening, representing 285 (47.5%) cases.