Adolescent presentations to an adult hospital emergency department

Noori, Omar; Batra, Shweta; Shetty, Amith; Steinbeck, Katharine

doi:10.1111/1742-6723.12842

Cited by 6 publications

(4 citation statements)

References 19 publications

(37 reference statements)

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“…Adolescents prefer to present as walk-in patients [ 21 ] and do so conspicuously often during the weekends [ 20 ]; this has also been observed in other studies. The most frequent triages in a study conducted in an Australian ED were—similar to our patients’ collective—semi-urgent (4/5) and non-urgent (5/5) [ 20 ]. Our data showed that there was a protective association with surgical treatment for walk-in patients.…”

Section: Discussionmentioning

confidence: 55%

“…Several ED studies, including our initial study, found that injuries were the most common cause of adolescent presentations to the ED [ 11 , 20 – 22 ]. Furthermore, studies have shown that in the age group of adolescents, males (52–60%) present to the ED more often than females [ 6 , 7 , 20 , 21 , 23 , 24 ]. For the subgroup of presentations due to trauma, this difference is even greater.…”

Section: Discussionmentioning

confidence: 99%

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Emergency department utilisation and treatment for trauma-related presentations of adolescents aged 16–18: a retrospective cross-sectional study

Brockhus,

Hofmann,

Keitel

et al. 2024

BMC Emerg Med

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Background A recent study conducted at our tertiary hospital emergency department (ED) reviewed ED consultations and found that adolescents aged 16–18 years present significantly more often for trauma and psychiatric problems than adults over 18 years. Accidental injuries are one of the greatest health risks for children and adolescents. In view of the increased vulnerability of the adolescent population, this study aimed to further analyse trauma-related presentations in adolescents. Methods We conducted a single-centre, retrospective, cross-sectional study of all adolescent trauma patients aged 16 to 18 years presenting to the adult ED at the University Hospital (Inselspital) in Bern, Switzerland, from January 2013 to July 2017. We analysed presentation data as well as inpatient treatment and cost-related data. Data of female and male patients were compared by univariable analysis. A comparison group was formed consisting of 200 randomly chosen patients aged 19–25 years old with the same presentation characteristics. Predictive factors for surgical treatment were obtained by multivariable analysis. Results The study population included a total of 1,626 adolescent patients aged 16–18 years. The predominant causes for ED presentation were consistent within case and comparison groups for sex and age and were sports accidents, falls and violence. Male patients were more likely to need surgical treatment (OR 1.8 [95% CI: 1.2–2.5], p = 0.001) and consequently inpatient treatment (OR 1.5 [95% CI: 1.1–2.1], p = 0.01), associated with higher costs (median 792 Swiss francs [IQR: 491-1,598]). Other independent risk factors for surgical treatment were violence-related visits (OR 2.1 [95% CI: 1.3–3.5, p = 0.004]) and trauma to the upper extremities (OR 2.02 [95% CI: 1.5–2.8], p < 0.001). Night shift (OR 0.56 [95% CI: 0.37–0.86], 0.008) and walk-in consultations (OR 0.3 [95% CI: 0.2; 0.4, < 0.001] were preventive factors for surgical treatment. Conclusions Male adolescents account for the majority of emergency visits and appear to be at higher risk for accidents as well as for surgical treatment and/or inpatient admission due to sports accidents or injuries from violence. We suggest that further preventive measures and recommendations should be implemented and that these should focus on sport activities and injuries from violence.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Emergency department utilisation and treatment for trauma-related presentations of adolescents aged 16–18: a retrospective cross-sectional study

Brockhus,

Hofmann,

Keitel

et al. 2024

BMC Emerg Med

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“…This finding aligns with specific study of paediatric ED utilisation in Melbourne during the first wave. 6 Adolescents aged 14–18 most commonly present to ED due to injuries, 22 and online supplemental figure 2 depicts a substantial reduction in injury presentation for those aged <18, and 18–40, during both waves. Observed reductions among young adults may reflect fewer road accidents and/or alcohol-related injuries (including violence and falls).…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 lockdowns on hospital presentations and admissions in the context of low community transmission: evidence from time series analysis in Melbourne, Australia

Collyer

Athanasopoulos

Srikanth

et al. 2021

J Epidemiol Community Health

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BackgroundMelbourne, Australia, successfully halted exponential transmission of COVID-19 via two strict lockdowns during 2020. The impact of such restrictions on healthcare-seeking behaviour is not comprehensively understood, but is of global importance. We explore the impact of the COVID-19 pandemic on acute, subacute and emergency department (ED) presentations/admissions within a tertiary, metropolitan health service in Melbourne, Australia, over two waves of community transmission (1 March to 20 September 2020).MethodsWe used 4 years of historical data and novel forecasting methods to predict counterfactual hospital activity for 2020, assuming absence of COVID-19. Observed activity was compared with forecasts overall, by age, triage category and for myocardial infarction and stroke. Data were analysed for all patients residing in the health service catchment area presenting between 4 January 2016 and 20 September 2020.ResultsED presentations (n=401 805), acute admissions (n=371 723) and subacute admissions (n=15 676) were analysed. Substantial departures from forecasted presentation levels were observed during both waves in the ED and acute settings, and during the second wave in subacute. Reductions were most marked among those aged >80 and <18 years. Presentations persisted at expected levels for urgent conditions, and ED triage categories 1 and 5, with clear reductions in categories 2–4.ConclusionsOur analyses suggest citizens were willing and able to present with life-threatening conditions during Melbourne’s lockdowns, and that switching to telemedicine did not cause widespread spill-over from primary care into ED. During a pandemic, lockdowns may not inhibit appropriate hospital attendance where rates of infectious disease are low.

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“…This is the first Australian study to explore adult ED clinician perspectives regarding AYA presentations. Most clinicians lacked specific adolescent health training and overestimated the actual burden of AYA chronic physical illness in EDs based on retrospective data 4 suggesting that such presentations are more memorable than prevalent.…”

Section: Transition Care and The Emergency Departmentmentioning

confidence: 99%

Transition care and the emergency department

Noori

Jackson

Shetty

et al. 2019

Emerg Medicine Australasia

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Adolescent presentations to an adult hospital emergency department

Abstract: Contrary to reported staff perceptions, adolescent chronic physical illness presentations were not a major burden. Alcohol was likely under-recorded as a contributing factor to presentations.

Cited by 6 publications

References 19 publications

Emergency department utilisation and treatment for trauma-related presentations of adolescents aged 16–18: a retrospective cross-sectional study

Emergency department utilisation and treatment for trauma-related presentations of adolescents aged 16–18: a retrospective cross-sectional study

Impact of COVID-19 lockdowns on hospital presentations and admissions in the context of low community transmission: evidence from time series analysis in Melbourne, Australia

Transition care and the emergency department

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