Objective: To describe the epidemiological and other characteristics of emergency department (ED) presentations diagnosed with acute upper respiratory infection (URI).
Design and setting:A retrospective study of patients given an ED diagnosis of acute URI from July 2000 to July 2003 at any of the four metropolitan teaching hospitals in Perth, Western Australia.Results: Acute URI accounted for 3.6% (95% CI, 3.5-3.7) of ED presentations, and 80.7% (95% CI, 80.1-81.3) of these were aged less than 15 years. The most common diagnosis was acute upper respiratory infections of multiple and unspecified sites, followed by croup and acute tonsillitis. Of those with croup, 76.0% (95% CI,3) presented at night, 67.6% (95% CI, 66.2-69.0) were male and the number of presentations with croup was highest in June 2002. The number of diagnoses of acute tonsillitis did not display a great deal of variation from month to month. Overall, hospital admission was 12.3% (95% CI, 11.8-12.8), with a median length of hospital stay of 1 day (IQR 1.0-2.0). An increase in comorbidity, residing in the most disadvantaged areas, and being a re-presentation increased the odds of being admitted.
Conclusion
What is known about the topic?Upper respiratory infection (URI) is a frequent problem managed in Australian general practice, and in the hospital setting, children and young adults account for most of the hospital separations for this condition. There are few published data relating to the frequency and other characteristics of acute URI presentations to hospital emergency departments.
What does this paper add?This study provides data on presentations (admitted and non-admitted) diagnosed with acute URI in hospital emergency departments. Those presenting were predominantly children, with very few requiring inpatient admission.
What are the implications for practitioners?This study provides baseline data which could be used when assessing changes in health service delivery. Further investigation is needed into why patients with less severe illnesses present to emergency departments and which, if any, alternative medical care services would be appropriate and acceptable for these patients.