Ilene Claudius1, Thomas Keens. 1. Division of Emergency and Transport Medicine, Keck School of Medicine, Childrens Hospital Los Angeles, 4650 Sunset Blvd, MS 113, Los Angeles, CA 90027, USA. iclaudius@chla.usc.edu
Abstract
OBJECTIVE: The goal was to identify criteria that would allow low-risk infants presenting with an apparent life-threatening event to be discharged safely from the emergency department. METHODS: We completed data forms prospectively on all previously healthy patients <12 months of age presenting to the emergency department of an urban tertiary care children's hospital with an apparent life-threatening event over a 3-year period. These patients were then observed for subsequent events, significant interventions, or final diagnoses that would have mandated their admission (eg, sepsis). RESULTS: In our population of 59 infants, all 8 children who met the aforementioned outcome measures, thus requiring admission, either had experienced multiple apparent life-threatening events before presentation or were in their first month of life. In our study group, the high-risk criteria of age of <1 month [corrected] and multiple apparent life-threatening events yielded a negative predictive value of 100% to identify the need for hospital admission. CONCLUSIONS: Our study suggests that >30-day-old infants who have experienced a single apparent life-threatening event may be discharged safely from the hospital, which would decrease admissions by 38%.
OBJECTIVE: The goal was to identify criteria that would allow low-risk infants presenting with an apparent life-threatening event to be discharged safely from the emergency department. METHODS: We completed data forms prospectively on all previously healthy patients <12 months of age presenting to the emergency department of an urban tertiary care children's hospital with an apparent life-threatening event over a 3-year period. These patients were then observed for subsequent events, significant interventions, or final diagnoses that would have mandated their admission (eg, sepsis). RESULTS: In our population of 59 infants, all 8 children who met the aforementioned outcome measures, thus requiring admission, either had experienced multiple apparent life-threatening events before presentation or were in their first month of life. In our study group, the high-risk criteria of age of <1 month [corrected] and multiple apparent life-threatening events yielded a negative predictive value of 100% to identify the need for hospital admission. CONCLUSIONS: Our study suggests that >30-day-old infants who have experienced a single apparent life-threatening event may be discharged safely from the hospital, which would decrease admissions by 38%.
Authors: Linda T Wang; Robert H Cleveland; William Binder; Robert G Zwerdling; Caterina Stamoulis; Thomas Ptak; Mindy Sherman; Kenan Haver; Pallavi Sagar; Patricia Hibberd Journal: BMJ Open Date: 2018-01-05 Impact factor: 2.692
Authors: Ben A Semmekrot; Bregje E van Sleuwen; Adele C Engelberts; Koen F M Joosten; Jaap C Mulder; K Djien Liem; Rob Rodrigues Pereira; Rob P G M Bijlmer; Monique P L'Hoir Journal: Eur J Pediatr Date: 2009-06-21 Impact factor: 3.183