From the Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children.
Pediatr Emerg Care. 2022 Apr 1;38(4):e1173-e1178. doi: 10.1097/PEC.0000000000002535.
The aims of the study were to measure overall trends and to identify leading causes for pediatric emergency department (ED) visits among children aged 0 to 4 years.
We conducted an 11-year population-based open cohort study using health administrative data from 2008 to 2018 in Ontario, Canada. All ED visits were extracted from the National Ambulatory Care Reporting System, along with the most responsible cause of each visit. Annual ED visit rates were calculated per 100 children in each year. Overall and disease-specific rates for all children were calculated and then stratified by sex and age groups. Relative percentage change in rates between 2008 and 2018 were calculated and compared using standardized differences (SDIFs). Statistical significance of time trends was tested using Poisson regression.
This study included an average of 911,566 children from 2008 to 2018. All-cause ED visit rates increased by 28.2% from 2008 to 2018 (43.24-55.42 per 100, SDIF >0.1). Respiratory diseases were consistently the top cause of ED visits, and contributed to 1 in 3 ED visits in 2018. These respiratory conditions include asthma, asthma-related diseases (bronchiolitis, bronchitis, influenza, and pneumonia), and other respiratory diseases. Respiratory ED visit rates increased by 32.8% from 2008 to 2018 (11.51-15.28 per 100, SDIF <0.1), driven by a 46.4% (14.58-21.35 per 100, SDIF >0.1) increase among children younger than 1 year. There was a 78.0% increase in ED visits for bronchiolitis in infants (1.45-2.58 per 100, SDIF <0.1).
Respiratory diseases like bronchiolitis among infants were the consistent leading cause for ED visits. All-cause ED visit rates among young children increased by 28.17% from 2008 to 2018.
本研究旨在衡量 0 至 4 岁儿童因儿科急诊就诊的总体趋势，并确定主要病因。
我们对加拿大安大略省 2008 年至 2018 年期间的健康管理数据进行了为期 11 年的基于人群的开放式队列研究。所有急诊就诊均从国家门诊护理报告系统中提取，同时还提取了每次就诊的主要病因。每年按每 100 名儿童计算急诊就诊率。计算所有儿童的总体和特定疾病就诊率，然后按性别和年龄组进行分层。使用标准化差异（SDIF）计算 2008 年至 2018 年期间就诊率的相对百分比变化，并进行比较。使用泊松回归检验时间趋势的统计学意义。
本研究纳入了 2008 年至 2018 年期间平均 911566 名儿童。2008 年至 2018 年期间，因所有病因导致的急诊就诊率增加了 28.2%（43.24-55.42/100，SDIF >0.1）。呼吸系统疾病一直是急诊就诊的首要原因，2018 年占急诊就诊的 1/3。这些呼吸系统疾病包括哮喘、哮喘相关疾病（细支气管炎、支气管炎、流感和肺炎）以及其他呼吸系统疾病。2008 年至 2018 年期间，呼吸系统疾病急诊就诊率增加了 32.8%（11.51-15.28/100，SDIF <0.1），其中 1 岁以下儿童的就诊率增加了 46.4%（14.58-21.35/100，SDIF >0.1）。婴儿细支气管炎的急诊就诊率增加了 78.0%（1.45-2.58/100，SDIF <0.1）。
像婴儿细支气管炎这样的呼吸系统疾病一直是急诊就诊的主要原因。2008 年至 2018 年期间，幼儿的所有病因急诊就诊率增加了 28.17%。
