Giri Samita, Halvas-Svendsen Tine, Rogne Tormod, Shrestha Sanu Krishna, Døllner Henrik, Solligård Erik, Risnes Kari
Norwegian University of Science and Technology, Trondheim, Norway.
Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
Glob Pediatr Health. 2020 Sep 18;7:2333794X20947926. doi: 10.1177/2333794X20947926. eCollection 2020.
In low-income countries, pediatric emergency care is largely underdeveloped although child mortality in emergency care is more than twice that of adults, and mortality after discharge is high. We aimed at describing characteristics, triage categories, and post-discharge mortality in a pediatric emergency population in Nepal. We prospectively assessed characteristics and triage categories of pediatric patients who entered the emergency department (ED) in a local hospital. Patient households were followed-up by telephone interviews at 90 days. The majority of pediatric emergency patients presented with injuries and infections (~40% each). Girls attended ED less frequent than boys. High triage priority categories (orange and red) were strong indicators for intensive care need and for mortality after discharge. The study supports the use and development of a pediatric triage systems in a low-resource general ED setting. We identify a need for interventions that can reduce mortality after pediatric emergency care. Interventions to reduce pediatric emergency disease burden in this setting should emphasize prevention and effective treatment of infections and injuries.
在低收入国家,儿科急诊护理在很大程度上发展不足,尽管急诊护理中的儿童死亡率是成人的两倍多,且出院后的死亡率很高。我们旨在描述尼泊尔儿科急诊人群的特征、分诊类别及出院后死亡率。我们前瞻性地评估了当地一家医院急诊科收治的儿科患者的特征和分诊类别。通过电话访谈对患者家庭进行了为期90天的随访。大多数儿科急诊患者表现为受伤和感染(各约占40%)。女孩就诊急诊科的频率低于男孩。高分诊优先级类别(橙色和红色)是需要重症监护及出院后死亡的有力指标。该研究支持在资源匮乏的综合急诊科环境中使用和开发儿科分诊系统。我们确定需要采取干预措施以降低儿科急诊护理后的死亡率。在此环境中,减轻儿科急诊疾病负担的干预措施应强调对感染和受伤的预防及有效治疗。