Can linked emergency department data help assess the out-of-hospital burden of acute lower respiratory infections? A population-based cohort study

BMC Public Health

Deborah Lehmann²  Peter Richmond¹  Peter Jacoby²  Nicholas de Klerk²  Hannah C Moore² 

[1] Department of Paediatric and Adolescent Medicine, Princess Margaret Hospital for Children, Perth, Australia;Division of Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia

关键词: Data linkage, Children;    Acute lower respiratory infection;    Outpatient;    Emergency department;   

Others  :  1163201
DOI  :  10.1186/1471-2458-12-703

 received in 2012-02-22, accepted in 2012-08-23,  发布年份 2012

【 摘 要 】

Background

There is a lack of data on the out-of-hospital burden of acute lower respiratory infections (ALRI) in developed countries. Administrative datasets from emergency departments (ED) may assist in addressing this.

Methods

We undertook a retrospective population-based study of ED presentations for respiratory-related reasons linked to birth data from 245,249 singleton live births in Western Australia. ED presentation rates <9 years of age were calculated for different diagnoses and predictors of ED presentation <5 years were assessed by multiple logistic regression.

Results

ED data from metropolitan WA, representing 178,810 births were available for analysis. From 35,136 presentations, 18,582 (52.9%) had an International Classification of Diseases (ICD) code for ALRI and 434 had a symptom code directly relating to an ALRI ICD code. A further 9600 presentations had a non-specific diagnosis. From the combined 19,016 ALRI presentations, the highest rates were in non-Aboriginal children aged 6–11 months (81.1/1000 child-years) and Aboriginal children aged 1–5 months (314.8/1000). Croup and bronchiolitis accounted for the majority of ALRI ED presentations. Of Aboriginal births, 14.2% presented at least once to ED before age 5 years compared to 6.5% of non-Aboriginal births. Male sex and maternal age <20 years for Aboriginal children and 20–29 years for non-Aboriginal children were the strongest predictors of presentation to ED with ALRI.

Conclusions

ED data can give an insight into the out-of-hospital burden of ALRI. Presentation rates to ED for ALRI were high, but are minimum estimates due to current limitations of the ED datasets. Recommendations for improvement of these data are provided. Despite these limitations, ALRI, in particular bronchiolitis and croup are important causes of presentation to paediatric EDs.

【 授权许可】

   
2012 Moore et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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