Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel.
Pediatric Emergency Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Emerg Med. 2022 Sep;59:70-73. doi: 10.1016/j.ajem.2022.06.061. Epub 2022 Jul 2.
The aim of this study was to assess the performance of the Pediatric Canadian Triage and Acuity Scale (PaedCTAS) in adolescent patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
A time-series study was conducted in the Emergency Departments (EDs) of 17 public hospitals during the Delta (B.1.617.2) variant spread in Israel. Data were collected prospectively from June 11, 2021 to August 15, 2021. Multivariate regression analyses were performed to identify independent variables associated with hospital admission and with admission to an Intensive Care Unit (ICU).
During the study period, 305 SARS-CoV-2 patients ages 12-18 years presenting to the ED were included, and 267 (87.5%) were unvaccinated. Sixty-seven (22.0%) and 12 (3.9%) patients were admitted to pediatric wards and ICUs, respectively. PaedCTAS level 1-2 and the presence of chronic disease increased the odds of hospital admission (adjusted odds ratio (aOR) 5.74, 95% CI, 2.30-14.35, p < 0.0001), and (aOR 2.9, 95% CI, 1.48-5.67, p < 0.02), respectively. PaedCTAS level 1-2 and respiratory symptoms on presentation to ED increased the odds of ICU admission (aOR 27.79; 95% CI, 3.85-176.91, p < 0.001), and (aOR 26.10; 95% CI, 4.47-172.63, p < 0.0001), respectively. PaedCTAS level 3-5 was found in 217/226 (96%) of the patients who were discharged home from the ED.
The findings suggest that PaedCTAS level 1-2 was the strongest factor associated with hospital and ICU admission. Almost all the patients who were discharged home had PaedCTAS level 3-5. Study findings suggest good performance of the PaedCTAS in this cohort.
本研究旨在评估儿科加拿大分诊和 acuity 量表（PaedCTAS）在严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）感染的青少年患者中的表现。
这是一项在以色列德尔塔（B.1.617.2）变体传播期间在 17 家公立医院急诊科进行的时间序列研究。数据从 2021 年 6 月 11 日至 2021 年 8 月 15 日前瞻性收集。进行多变量回归分析以确定与住院和入住重症监护病房（ICU）相关的独立变量。
在研究期间，纳入了 305 名年龄在 12-18 岁的 SARS-CoV-2 患者到急诊科就诊，其中 267 名（87.5%）未接种疫苗。67 名（22.0%）和 12 名（3.9%）患者分别被收治到儿科病房和 ICU。PaedCTAS 级别 1-2 和存在慢性病增加了住院的几率（调整后的优势比（aOR）5.74，95%置信区间，2.30-14.35，p<0.0001），和（aOR 2.9，95%置信区间，1.48-5.67，p<0.02）。PaedCTAS 级别 1-2 和急诊科就诊时的呼吸症状增加了 ICU 入住的几率（aOR 27.79；95%置信区间，3.85-176.91，p<0.001），和（aOR 26.10；95%置信区间，4.47-172.63，p<0.0001）。在从急诊科出院回家的 226 名患者中的 217 名（96%）患者中发现 PaedCTAS 级别 3-5。
研究结果表明，PaedCTAS 级别 1-2 是与住院和 ICU 入院最相关的因素。几乎所有出院回家的患者 PaedCTAS 级别都在 3-5。研究结果表明，该队列中 PaedCTAS 的表现良好。
