The value of referral status as a solitary indicator to predict severity of illness in children

Abstract

Abstracts ingediend voor het Amsterdam Kindersymposium 2013 39 The value of referral status as a solitary indicator to predict severity of illness in children Anouk L.M. Eikendal, Fleur de Lorijn, Sabien G.J. Heisterkamp, Chris C. de Krui ff , Diederik K. Bosman Department of general paediatrics, Emma Children’s Hospital AMC OBJECTIVE To assess whether referral status of children who present in an Emergency Department is an adequate indicator to predict severity of illness. METHODS A prospective, cross-sectional study was performed. During fi ve months, we performed data collections of all children who presented at the Emergency Department of the Academic Medical Centre. Children with most prevalent paediatric, non-surgical complaints were included. Markers for severity of illness that were obtained and analyzed were urgency classifi cation according to the Manchester Triage System, abnormal vital signs at presenta-tion, and admittance were performed. RESULTS Of 941 eligible children, 353 (37.5%) were referred and 588 (62.5%) were self-referred. With adjustment for age and gender, referred patients were signifi cantly more likely to have urgent triage categories (P<0.001); one or more abnormal vital signs at presentation (P=0.003); additional diagnostics performed (P=0.001); be admitted (P<0.001) or have a longer duration of admittance (P=0.009) when compared to self-referred patients. 41.2% of the self-referred children, only seen by an EP and sent home, had an urgent triage category. 19.3% of this group had one or more abnormal vital signs at presentation.