Bellini Tommaso, Fueri Elena, Formigoni Clelia, Mariani Marcello, Villa Giovanna, Finetti Martina, Marin Marta, De Chiara Elena, Bratta Anna, Vanorio Barbara, Casabona Federica, Pepino Carlotta, Castagnola Elio, Piccotti Emanuela, Moscatelli Andrea
Paediatric Emergency Room and Emergency Medicine Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, via G. Gaslini, 5, 16147 Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16147 Genoa, Italy.
J Clin Med. 2024 Dec 3;13(23):7368. doi: 10.3390/jcm13237368.
: Respiratory tract infections (RTIs) are a leading cause of pediatric emergency department (PED) visits, especially in children under five. These infections are primarily viral, complicating diagnosis and management. This study assesses the impact of point-of-care (POC) rapid diagnostic tests for respiratory viruses on clinical and economic outcomes in a PED setting. A retrospective analysis of 1396 POC tests for RSV, adenovirus, and influenza A/B was conducted in the PED of the Giannina Gaslini Institute, Genoa, Italy, from December 2022 to April 2024. Demographics, blood tests, admissions, and readmission rates were evaluated. Statistical analyses were performed using appropriate tests for categorical and continuous variables. Of the tests, 31.5% were positive for at least one virus. Positive patients were younger and had higher hospitalization rates (50.7% vs. 39.9%) but fewer blood tests (38.2% vs. 51.7%). Economic analysis indicated lower costs for virus-positive patients. RSV-positive patients showed a significant association with higher hospitalization rates (67.8%) and readmission within 72 h. POC testing significantly improves patient management in PEDs by enabling rapid diagnoses, reducing unnecessary tests and hospitalizations, and guiding appropriate treatment. This approach supports better resource allocation, crucial during peak seasons, and has implications for reducing antibiotic use and resistance. Further research is warranted to explore long-term impacts on patient outcomes and healthcare efficiency.
呼吸道感染（RTIs）是儿科急诊科（PED）就诊的主要原因，尤其是在五岁以下儿童中。这些感染主要是病毒性的，使诊断和管理变得复杂。本研究评估了针对呼吸道病毒的即时检验（POC）快速诊断测试对儿科急诊科临床和经济结果的影响。对2022年12月至2024年4月在意大利热那亚吉安尼娜·加斯利尼研究所儿科急诊科进行的1396次呼吸道合胞病毒（RSV）、腺病毒和甲型/乙型流感病毒的即时检验进行了回顾性分析。评估了人口统计学、血液检查、住院情况和再入院率。使用适用于分类变量和连续变量的检验进行统计分析。在这些检验中，31.5%的结果显示至少有一种病毒呈阳性。检测结果呈阳性的患者年龄更小，住院率更高（50.7%对39.9%），但血液检查次数更少（38.2%对51.7%）。经济分析表明病毒检测呈阳性的患者成本更低。RSV检测呈阳性的患者与更高的住院率（67.8%）和72小时内的再入院率显著相关。即时检验通过实现快速诊断、减少不必要的检查和住院以及指导适当治疗，显著改善了儿科急诊科的患者管理。这种方法有助于在高峰期更好地分配资源，这至关重要，并且对减少抗生素使用和耐药性具有重要意义。有必要进行进一步研究，以探索对患者结局和医疗效率的长期影响。
