Enyuma Callistus Oa, Anah Maxwell U, Pousson Amelia, Olorunfemi G, Ibisomi L, Abang B E, Imoke E J
Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Paediatrics, Faculty of Medicine, University of Calabar, Nigeria.
Afr Health Sci. 2019 Jun;19(2):1910-1923. doi: 10.4314/ahs.v19i2.14.
There is a high prevalence of paediatric emergency cases in less developed countries. However, prolonged hospital stay at emergency units may further overstretch the facilities.
To assess the patterns of presentations, services offered and predictors of a prolonged stay at the Children Emergency Room of a tertiary hospital in Southern Nigeria.
This prospective cross-sectional, study was conducted at the University of Calabar Teaching Hospital, Nigeria from 1 January-31 December 2014. Socio-demographic and clinical characteristics of consecutively recruited children (n=633) were recorded in a proforma. Binary logistic regression was conducted to determine predictors of prolonged stay (>72 hours).
The median age of participants was 2 (1 - 4.6) years. Three-fifths of children were admitted at off-hours and the commonest symptom was fever (73.9%). About 16.4% (95%CI:13.6% - 19.4%, n= 103/633) of the children had prolonged stay while those with sepsis had the longest mean stay (65.5±72.1 hours). Children admitted on account of Sickle cell disease (OR:11.2, 95%CI:1.3-95.1, P-value = 0.03), Malaria (OR:10.7, 95%CI:1.4-82.5, P-value = 0.02) or sepsis (OR:10.5, 95%CI:1.3 - 82.7, P-value = 0.03) had higher odds of prolonged hospital stay. There was no significant difference in hospital stay among children admitted by the consultant as compared to other health personnel (P-value = 0.08).
Prevention and proper management of Sickle cell disease and malaria reduces paediatric hospital stay in our environment. Paediatric emergency medicine should be re-organized to cater for high volume of off-hour admissions.
在欠发达国家，儿科急诊病例的患病率很高。然而，在急诊科室长时间住院可能会进一步使医疗设施不堪重负。
评估尼日利亚南部一家三级医院儿童急诊室的就诊模式、提供的服务以及延长住院时间的预测因素。
这项前瞻性横断面研究于2014年1月1日至12月31日在尼日利亚卡拉巴尔大学教学医院进行。用一份表格记录连续招募的儿童（n = 633）的社会人口统计学和临床特征。进行二元逻辑回归以确定延长住院时间（> 72小时）的预测因素。
参与者的中位年龄为2（1 - 4.6）岁。五分之三的儿童在非工作时间入院，最常见的症状是发热（73.9%）。约16.4%（95%置信区间：13.6% - 19.4%，n = 103/633）的儿童住院时间延长，而患有败血症的儿童平均住院时间最长（65.5±72.1小时）。因镰状细胞病入院的儿童（比值比：11.2，95%置信区间：1.3 - 95.1，P值 = 0.03）、疟疾（比值比：10.7，95%置信区间：1.4 - 82.5，P值 = 0.02）或败血症（比值比：10.5，95%置信区间：1.3 - 82.7，P值 = 0.03）延长住院时间的几率更高。与其他医务人员相比，由顾问收治的儿童住院时间没有显著差异（P值 = 0.08）。
预防和妥善管理镰状细胞病和疟疾可减少我们地区儿科住院时间。应重新组织儿科急诊医学以应对大量非工作时间入院的情况。
