Institute of Pediatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168, Rome, Italy.
Institute of Pediatrics, Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Rome, Italy.
Ital J Pediatr. 2021 Jan 18;47(1):11. doi: 10.1186/s13052-021-00959-z.
Observation Units (OU), as part of emergency department (ED), are areas reserved for short-term treatment or observation of patients with selected diagnoses to determine the need for hospitalization or home referral.
In this retrospective cohort study, we analyzed similarities and differences of children admitted to the pediatric ED of the Fondazione Policlinico Universitario A. Gemelli IRCCS hospital in the first 2 years of OU activity, analyzing general patient characteristics, access modalities, diagnosis, triage, laboratory and instrumental examinations, specialist visits, outcome of OU admission and average time spent in OU. Furthermore, we compared total numbers and type of hospitalization of the first 2 years of OU activity with those of previous 2 years.
The most frequent diagnoses were abdominal pain, minor head injury without loss of consciousness, vomiting, epilepsy and acute bronchiolitis. The most performed laboratory examinations were blood count. The most commonly performed instrumental examination was abdominal ultrasound. Neurological counseling was the most commonly requested. Average time spent in OU was 13 h in 2016 and 14.1 h in 2017. Most OU admissions did not last longer than 24 h (90.5% in 2016 and 89.5% in 2017). In the years 2014-2015, 13.4% of pediatric patients accessing the ED were hospitalized, versus 9.9% the years 2016-2017 reducing pediatric hospital admissions by 3.6% (p < 0.001).
This study demonstrate that OU is a valid alternative to ordinary wards for specific pathologies. In accordance with the literature, our study showed that, in the first 2 years of the OU activity, admissions to hospital ward decreased compared with the previous 2 years with an increase of complex patients.
观察单元（OU）作为急诊部（ED）的一部分，是为有特定诊断的患者提供短期治疗或观察的区域，以确定住院或家庭转介的需求。
在这项回顾性队列研究中，我们分析了 OU 活动的前 2 年期间收入儿科 ED 的儿童的相似和不同之处，分析了一般患者特征、就诊方式、诊断、分诊、实验室和仪器检查、专科就诊、OU 入院结果和 OU 停留时间。此外，我们比较了 OU 活动前 2 年和前 2 年的总住院人数和类型。
最常见的诊断是腹痛、无昏迷的轻微头部损伤、呕吐、癫痫和急性细支气管炎。最常进行的实验室检查是血常规。最常进行的仪器检查是腹部超声。最常要求进行神经科咨询。OU 停留时间在 2016 年为 13 小时，在 2017 年为 14.1 小时。大多数 OU 入院时间不超过 24 小时（2016 年为 90.5%，2017 年为 89.5%）。在 2014-2015 年，进入 ED 的儿科患者中有 13.4%住院，而在 2016-2017 年期间，这一比例为 9.9%，减少了 3.6%的儿科住院（p<0.001）。
这项研究表明，OU 是特定疾病普通病房的有效替代方案。与文献一致，我们的研究表明，在 OU 活动的前 2 年，与前 2 年相比，住院病房的入院人数减少，而复杂患者的人数增加。
