Pant Chaitanya, Deshpande Abhishek, Sferra Thomas J, Olyaee Mojtaba
Division of Gastroenterology, Hepatology and Motility, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
Medicine Institute Center for Value Based Care Research, Cleveland Clinic, Cleveland, Ohio, USA.
J Investig Med. 2017 Apr;65(4):803-806. doi: 10.1136/jim-2016-000300. Epub 2017 Jan 10.
To analyze visits to and admissions from the emergency department (ED) in children with a primary diagnosis of functional abdominal pain (FAP). This was a cross-sectional study using data from the Nationwide Emergency Department Sample (HCUP-NEDS 2008-2012). FAP-related ED visits were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The most frequent secondary diagnoses associated with FAP-related ED visits were also extracted. In 2012, a total of 796,665 children presented to the ED with a primary diagnosis of FAP. This correlated to a rate of 11.5 ED visits/1000 population. The highest incidence of ED visits was observed for children in the 10-14-year age group; median (IQR) age of 11 (8) years. In analyzing the temporal trends associated with FAP-related ED visits, we observed an increase in both the overall number of visits (14.0%) as well as the population-adjusted incidence (16.0%) during the period 2008-2012. This coincided with a decreasing trend in hospital admissions from the ED; from 1.4% in 2008 to 1.0% in 2012 (-28.5%). The overwhelming majority (96.7%) of patients with FAP who presented to the ED were treated and released. On multivariate analysis, the leading factor associated with an increased likelihood of admission from the ED was teaching hospital status (aOR 2.07; 95% CI 1.97 to 2.18). The secondary diagnosis most commonly associated with FAP-related ED visits was nausea and/or emesis (19.8%). Pediatric FAP-related ED visits increased significantly from the period 2008 to 2012. However, the incidence of hospital admissions from the ED declined during the same period.
分析以功能性腹痛(FAP)为主要诊断的儿童到急诊科(ED)就诊及住院情况。这是一项横断面研究,使用了来自全国急诊科样本(HCUP-NEDS 2008 - 2012)的数据。通过国际疾病分类第九版临床修订本代码识别与FAP相关的急诊科就诊情况。还提取了与FAP相关的急诊科就诊最常见的次要诊断。2012年,共有796,665名儿童以FAP为主要诊断到急诊科就诊。这相当于每1000人口中有11.5次急诊科就诊率。10 - 14岁年龄组的儿童急诊科就诊率最高;中位(IQR)年龄为11(8)岁。在分析与FAP相关的急诊科就诊的时间趋势时,我们观察到2008 - 2012年期间就诊总数(增加了14.0%)以及经人口调整的发病率(增加了16.0%)均有所上升。这与急诊科住院人数的下降趋势相吻合;从2008年的1.4%降至2012年的1.0%(下降了28.5%)。到急诊科就诊的FAP患者绝大多数(96.7%)接受治疗后出院。多因素分析显示,与急诊科住院可能性增加相关的主要因素是教学医院身份(调整后比值比2.07;95%可信区间1.97至2.18)。与FAP相关的急诊科就诊最常伴发的次要诊断是恶心和/或呕吐(19.8%)。2008年至2012年期间,儿科FAP相关的急诊科就诊显著增加。然而,同期急诊科住院率下降。