From the Department of Pediatrics, Division of Pediatrics Emergency Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston.
South Med J. 2024 Sep;117(9):543-548. doi: 10.14423/SMJ.0000000000001734.
Emergency department observation units (EDOUs) are used to manage common pediatric illnesses and reduce the admission rate to the hospital. Most of these patients require a short duration of observation before a determination can be made whether they need to be admitted to the hospital or safely discharged home. The purpose of this study was to determine the characteristics of admissions from a pediatric EDOU for the top 10 diagnoses admitted to the unit. This will help standardize the disposition of such types of patients from the ED, hence improving the efficiency of the unit.
We did a retrospective surveillance study of admitted patients from 0 to 18 years of age from the EDOU for the top 10 diagnoses. Descriptive data were reported using percentages and medians with interquartile ranges. Pearson χ tests were used to determine significant differences ( < 0.05) between the reason for admission and medical history.
In total, 520 patients were admitted from the EDOU during the study period. The median patient age was 3.39 years, with most being Hispanic and female. The top three primary diagnoses of all admitted patients were cellulitis and abscess, gastroenteritis, and bronchiolitis. Sixty-three percent of all admitted patients had secondary diagnoses. Most of these patients were admitted to the inpatient unit due to progression of the primary condition.
The characteristics of admissions from the EDOU may help us to understand historical experience regarding diagnoses, timing, and indications of deterioration, resource utilization, and other metrics that resulted in transfers of EDOU patients to the intensive care unit/operating room/inpatient units.
急诊观察病房（EDOU）用于治疗常见儿科疾病，降低住院率。这些患者大多需要短时间的观察，才能确定是否需要住院或安全出院。本研究的目的是确定进入儿科 EDOU 的前 10 种诊断的患者的入院特征。这将有助于规范此类患者从 ED 的出院方式，从而提高该病房的效率。
我们对 EDOU 中因前 10 种诊断而入院的 0 至 18 岁患者进行了回顾性监测研究。采用百分比和中位数（四分位距）报告描述性数据。采用 Pearson χ 检验来确定入院原因和病史之间的显著差异（<0.05）。
在研究期间，共有 520 名患者从 EDOU 入院。中位患者年龄为 3.39 岁，多数为西班牙裔和女性。所有入院患者的前三个主要诊断为蜂窝织炎和脓肿、胃肠炎和细支气管炎。所有入院患者中有 63%有次要诊断。这些患者大多因主要疾病的进展而转入住院部。
EDOU 患者入院的特征可以帮助我们了解与诊断、时机、恶化迹象、资源利用以及导致 EDOU 患者转入重症监护室/手术室/住院部的其他指标有关的历史经验。
