Department of Emergency Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Pediatrics, Division of Pediatrics Neurology, King Abdulaziz University, Jeddah, Saudi Arabia.
J Med Life. 2024 Apr;17(4):432-441. doi: 10.25122/jml-2023-0476.
Pediatric neurological emergencies are a significant concern, often leading to high rates of admission to pediatric intensive care units and increased mortality rates. In Saudi Arabia, the emergency department (ED) is the main entry point for most patients in the healthcare system. This study aimed to provide a comprehensive overview of pediatric neurology visits to the ED, analyzing patient demographics, clinical presentations, and outcomes. The retrospective study was conducted at a large tertiary care center and examined 960 pediatric patients with neurological emergencies out of 24,088 pediatric ED visits. The study population consisted mainly of male participants (56.5%) and 43.5% female participants, with a mean age of 5.29 ± 4.19 years. School-age children (6-12 years) represented the largest population group (29.1%), and over a third of patients were triaged as 'resuscitation' ( = 332, 34.6%). Seizures ( = 317, 33.0%) and postictal states ( = 187, 19.5%) were the most common reasons for seeking emergency care, accounting for over half of all cases. There were statistically significant differences in provisional diagnosis and chief complaints across different age groups ( >0.001 and <0.001, respectively). The most common outcome was discharge ( = 558; 58.1%), and the mean length of stay was 10.56 ± 20.33 hours. Neuro-emergencies in pediatrics are a concern and a leading cause of mortality, morbidities, and increased hospital visits. The observed variations in presentation and outcomes across age groups further emphasize the importance of tailored approaches.
儿科神经急症是一个严重的问题，往往导致高比例的患儿入住儿科重症监护病房和死亡率上升。在沙特阿拉伯，急诊科（ED）是大多数患者进入医疗系统的主要入口。本研究旨在全面概述儿科神经急症到 ED 的就诊情况，分析患者人口统计学特征、临床表现和结局。这项回顾性研究在一家大型三级护理中心进行，共检查了 24088 例儿科 ED 就诊中 960 例患有神经急症的儿科患者。研究人群主要由男性参与者（56.5%）和 43.5%的女性参与者组成，平均年龄为 5.29 ± 4.19 岁。学龄儿童（6-12 岁）占最大的人群（29.1%），超过三分之一的患者被分诊为“复苏”（=332，34.6%）。癫痫发作（=317，33.0%）和癫痫发作后状态（=187，19.5%）是寻求紧急护理最常见的原因，占所有病例的一半以上。不同年龄组之间的临时诊断和主要投诉存在统计学显著差异（>0.001 和<0.001）。最常见的结局是出院（=558；58.1%），平均住院时间为 10.56 ± 20.33 小时。儿科神经急症是一个关注点，也是导致死亡率、发病率和增加住院次数的主要原因。观察到的不同年龄段的表现和结局的差异进一步强调了采用量身定制方法的重要性。
