School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Marmara University, Istanbul, Turkey.
Division of Community and Societal Pediatrics, University of FL College of Medicine-Jacksonville, Jacksonville, FL, USA.
Eur J Pediatr. 2022 Aug;181(8):2953-2960. doi: 10.1007/s00431-022-04499-4. Epub 2022 May 19.
Evaluation of emergency department (ED) presentation by Syrian refugee children might provide important information about their health care needs. For this purpose, we compared ED presentation of refugee and resident children in a tertiary university hospital in Istanbul, Turkey.Electronic medical records of Syrian refugee children ≤ 18 years old presenting to the ED between January 2013 and July 2019 were retrospectively reviewed and compared with resident children.The study population consisted of 7299 refugees and 690,127 resident children admitted to the ED. High-acuity cases were more frequent in Syrian refugees (2.2% vs 1% p < 0.001). One-third of Syrian children were under 12 months of age (31% vs 17%, p < 0.001). Syrian children were more commonly hospitalized (7.9% vs 3.1% p < 0.001). The median age (and interquartile range - IQR) was lower in hospitalized refugee than in resident children [12 (0-83) months vs 41 (8-111) months, p < 0.001]. Rate of intensive care unit hospitalization (13% vs 9.4%, p = 0.001) and neonatal hospitalization was higher in Syrians compared to resident children (29% vs 12%, p < 0.001). The median NICU stay was longer in refugees [6 (IQR 4-17) days vs 3 (IQR 1-9) days, p < 0.001].
Refugee children, as compared to resident children, are more likely to present to the ED with high acuity conditions and at a younger age resulting in higher rates of inpatient admissions. Strategies to increase access to preventive health care services for young refugee children should be explored to decrease ED and hospital services and improve health outcomes.
• Children are the most affected victims of armed conflicts in terms of health outcomes. • Refugees prefer to access healthcare through the emergency department.
• Refugee children were more likely to present as urgent when compared to resident children. • Admission to neonatal and intensive care units was more frequent among refugee than resident children.
评估叙利亚难民儿童在急诊科（ED）的就诊情况，可能有助于了解其医疗保健需求。为此，我们比较了土耳其伊斯坦布尔一所三级大学医院中难民和本地儿童的 ED 就诊情况。
回顾性分析了 2013 年 1 月至 2019 年 7 月期间在 ED 就诊的≤18 岁叙利亚难民儿童的电子病历，并与本地儿童进行了比较。
研究人群包括 7299 名难民和 690127 名本地儿童。叙利亚难民中高急症病例更为常见（2.2%比 1%，p<0.001）。三分之一的叙利亚儿童年龄在 12 个月以下（31%比 17%，p<0.001）。叙利亚儿童更常住院（7.9%比 3.1%，p<0.001）。与本地儿童相比，住院的难民儿童中位年龄（四分位距-IQR）更低[12（0-83）个月比 41（8-111）个月，p<0.001]。与本地儿童相比，难民儿童入住重症监护病房（13%比 9.4%，p=0.001）和新生儿病房的比例更高（29%比 12%，p<0.001）。与本地儿童相比，难民儿童入住新生儿重症监护病房的中位时间更长[6（IQR 4-17）天比 3（IQR 1-9）天，p<0.001]。
与本地儿童相比，难民儿童更有可能因急症情况就诊，且就诊年龄更小，导致住院率更高。应探索增加对年轻难民儿童的预防保健服务的途径，以减少 ED 和医院服务的使用，并改善健康结果。
