Investigating Associated Factors Between Admission to Pediatric Emergency and Referral to Intensive Care Unit: A Retrospective Cohort Study

Abstract

We aimed to evaluate the patients who were admitted to Pediatric Emergency Department regarding the ratio of referral to Intensive Care Unit (ICU), and the relationship between the time of waiting in Emergency Department and the length of stay in Intensive Care Unit between January 2013 and December 2018. Materials and Methods:The patients' records who were admitted to our Pediatric Emergency Department between January 2013 and December 2018 were evaluated retrospectively. The referrals to Neonatal and Pediatric ICU were evaluated. Due to the absence of an Intensive Care Unit in our hospital, we compared the duration of referral to ICU and length of stay in ICU. Results:The total number of patients who were admitted to Emergency Service was 673023, the number of the patients referred to ICU was 1327, 302 of these patients were referred to the Pediatric ICU (PICU), and the rest of them were referred to Neonatal ICU (NICU). While 47.35% of the patients who were referred to the PICU presented with respiratory tract diseases, 19.86% had neurological causes, 13.9% were intoxications, and 7.8% were gastrointestinal causes. 28.78% of the patients who were referred to the PICU had an accompanying chronic disease at the time of admission. Mean duration of referral to the PICU was 8.4 ± 6.3 hours. The length of stay of in PICU in 2017 and 2018 was investigated by asking on the phone (n = 122), and the mean length of stay of the patients in the PICU was 5.18 ± 2.1 days. There was no statistically significant correlation between the duration of referral to the ICU and the length of stay in the PICU (p; 0.089), whereas in 54 patients who presented to the emergency department due to respiratory distress and had no underlying chronic disease, there was a statistically significant correlation between the duration of referral to ICU and the length of stay in ICU (p: 0.012). Conclusion:The number of Pediatric Emergency Department admissions is very high in our country and most of these patients present with respiratory complaints. 0.19% of the patients who were admitted to the emergency service were in need of intensive care. Patients who had no underlying disease and who needed intensive care for respiratory distress were shown to have a shorter length of stay, and their referrals were faster. These patients should be referred to intensive care units without delay in the emergency service. As a conclusion, there is a need for more PICU in our country.