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Emergency medical services utilisation among febrile children attending emergency departments across Europe: an observational multicentre study

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Τίτλος: Emergency medical services utilisation among febrile children attending emergency departments across Europe: an observational multicentre study
Συγγραφείς: Tan, CD, Vermont, CL, Zachariasse, JM, von Both, U, Eleftheriou, I, Emonts, M, van der Flier, M, Herberg, J, Kohlmaier, B, Levin, M, Lim, E, Maconochie, IK, Martinon-Torres, F, Nijman, RG, Pokorn, M, Rivero-Calle, I, Tsolia, M, Zenz, W, Zavadska, D, Moll, HA, Carrol, ED, Cunnington, A, De, T, Kaforou, M, Wright, V, Baumard, L, Bellos, E, D’Souza, G, Galassini, R, Habgood-Coote, D, Hamilton, S, Hoggart, C, Hourmat, S, Jackson, H, Menikou, S, Lin, N, Nichols, S, Paz, IP, Shah, P, Shen, CF, Vito, O, Wilson, C, Abdulla, A, Ali, L, Darnell, S, Jorgensen, R, Mustafa, S, Persand, S, Stevens, M, Kim, E, Pierce, B, Fidler, K, Dudley, J, Richmond, V, Tavliavini, E, Liu, CC, Wang, SM, Salas, A, González, FÁ, Farto, CB, Barral-Arca, R, Castro, MB, Bello, X, García, MB, Carnota, S, Cebey-López, M, CurrasTuala, MJ, Suárez, CD, Vicente, LG, Gómez-Carballa, A, Rial, JG, Iglesias, PL, Martinón-Torres, N, Martinón Sánchez, JM, Pérez, BM, Pardo-Seco, J, Rodríguez, LP, Pischedda, S, Vázquez, SR, Calle, IR, Rodríguez-Tenreiro, C, Redondo-Collazo, L, Ora, MS, Fernández, SS, Trasorras, CS, Iglesias, MV, Balode, A, Bārzdiņa, A, Deksne, D, Gardovska, D, Grāvele, D, Grope, I, Meiere, A, Nokalna, I, Pavāre, J, Pučuka, Z, Selecka, K
Πηγή: European Journal of Pediatrics , 182 (9) pp. 3939-3947. (2023)
Στοιχεία εκδότη: Springer Science and Business Media LLC
Έτος έκδοσης: 2023
Συλλογή: University College London: UCL Discovery
Θεματικοί όροι: Emergency medical services, Emergency care, Children, Fever, Paediatrics
Περιγραφή: Children constitute 6–10% of all patients attending the emergency department (ED) by emergency medical services (EMS). However, discordant EMS use in children occurs in 37–61% with fever as an important risk factor. We aimed to describe EMS utilisation among febrile children attending European EDs. This study is part of an observational multicentre study assessing management and outcome in febrile children up to 18 years (MOFICHE) attending twelve EDs in eight European countries. Discordant EMS use was defined as the absence of markers of urgency including intermediate/high triage urgency, advanced diagnostics, treatment, and admission in children transferred by EMS. Multivariable logistic regression analyses were performed for the association between (1) EMS use and markers of urgency, and (2) patient characteristics and discordant EMS use after adjusting all analyses for the covariates age, gender, visiting hours, presenting symptoms, and ED setting. A total of 5464 (15%, range 0.1–42%) children attended the ED by EMS. Markers of urgency were more frequently present in the EMS group compared with the non-EMS group. Discordant EMS use occurred in 1601 children (29%, range 1–59%). Age and gender were not associated with discordant EMS use, whereas neurological symptoms were associated with less discordant EMS use (aOR 0.2, 95%CI 0.1–0.2), and attendance out of office hours was associated with more discordant EMS use (aOR 1.6, 95%CI 1.4–1.9). Settings with higher percentage of self-referrals to the ED had more discordant EMS use (p < 0.05). Conclusion: There is large practice variation in EMS use in febrile children attending European EDs. Markers of urgency were more frequently present in children in the EMS group. However, discordant EMS use occurred in 29%. Further research is needed on non-medical factors influencing discordant EMS use in febrile children across Europe, so that pre-emptive strategies can be implemented. What is Known: •Children constitute around 6–10% of all patients attending the ...
Τύπος εγγράφου: article in journal/newspaper
Περιγραφή αρχείου: application/pdf
Γλώσσα: English
Relation: https://discovery.ucl.ac.uk/id/eprint/10215780/1/Emergency%20medical%20services%20utilisation%20among%20febrile%20children%20attending%20emergency%20departments%20across%20Europe%20an%20observational.pdf; https://discovery.ucl.ac.uk/id/eprint/10215780/
Διαθεσιμότητα: https://discovery.ucl.ac.uk/id/eprint/10215780/1/Emergency%20medical%20services%20utilisation%20among%20febrile%20children%20attending%20emergency%20departments%20across%20Europe%20an%20observational.pdf
https://discovery.ucl.ac.uk/id/eprint/10215780/
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  Data: Emergency medical services utilisation among febrile children attending emergency departments across Europe: an observational multicentre study
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  Data: European Journal of Pediatrics , 182 (9) pp. 3939-3947. (2023)
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  Data: Children constitute 6–10% of all patients attending the emergency department (ED) by emergency medical services (EMS). However, discordant EMS use in children occurs in 37–61% with fever as an important risk factor. We aimed to describe EMS utilisation among febrile children attending European EDs. This study is part of an observational multicentre study assessing management and outcome in febrile children up to 18 years (MOFICHE) attending twelve EDs in eight European countries. Discordant EMS use was defined as the absence of markers of urgency including intermediate/high triage urgency, advanced diagnostics, treatment, and admission in children transferred by EMS. Multivariable logistic regression analyses were performed for the association between (1) EMS use and markers of urgency, and (2) patient characteristics and discordant EMS use after adjusting all analyses for the covariates age, gender, visiting hours, presenting symptoms, and ED setting. A total of 5464 (15%, range 0.1–42%) children attended the ED by EMS. Markers of urgency were more frequently present in the EMS group compared with the non-EMS group. Discordant EMS use occurred in 1601 children (29%, range 1–59%). Age and gender were not associated with discordant EMS use, whereas neurological symptoms were associated with less discordant EMS use (aOR 0.2, 95%CI 0.1–0.2), and attendance out of office hours was associated with more discordant EMS use (aOR 1.6, 95%CI 1.4–1.9). Settings with higher percentage of self-referrals to the ED had more discordant EMS use (p &lt; 0.05). Conclusion: There is large practice variation in EMS use in febrile children attending European EDs. Markers of urgency were more frequently present in children in the EMS group. However, discordant EMS use occurred in 29%. Further research is needed on non-medical factors influencing discordant EMS use in febrile children across Europe, so that pre-emptive strategies can be implemented. What is Known: •Children constitute around 6–10% of all patients attending the ...
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  Data: https://discovery.ucl.ac.uk/id/eprint/10215780/1/Emergency%20medical%20services%20utilisation%20among%20febrile%20children%20attending%20emergency%20departments%20across%20Europe%20an%20observational.pdf; https://discovery.ucl.ac.uk/id/eprint/10215780/
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  Data: https://discovery.ucl.ac.uk/id/eprint/10215780/1/Emergency%20medical%20services%20utilisation%20among%20febrile%20children%20attending%20emergency%20departments%20across%20Europe%20an%20observational.pdf&lt;br /&gt;https://discovery.ucl.ac.uk/id/eprint/10215780/
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  Data: edsbas.D43D53AF
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      – Text: English
    Subjects:
      – SubjectFull: Emergency medical services
        Type: general
      – SubjectFull: Emergency care
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Fever
        Type: general
      – SubjectFull: Paediatrics
        Type: general
    Titles:
      – TitleFull: Emergency medical services utilisation among febrile children attending emergency departments across Europe: an observational multicentre study
        Type: main
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            – D: 01
              M: 01
              Type: published
              Y: 2023
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          Titles:
            – TitleFull: European Journal of Pediatrics , 182 (9) pp. 3939-3947. (2023
              Type: main
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