Respiratory Virus-related Emergency Department Visits and Hospitalizations Among Infants in New Zealand.


Journal

The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858

Informations de publication

Date de publication:
08 2020
Historique:
entrez: 18 7 2020
pubmed: 18 7 2020
medline: 16 7 2021
Statut: ppublish

Résumé

Estimates of the contribution of respiratory viruses to emergency department (ED) utilization remain limited. We conducted surveillance of infants with acute respiratory infection (ARI) associated ED visits, which then resulted in either hospital admission or discharge home. Seasonal rates of specific viruses stratified by age, ethnicity, and socioeconomic status were estimated for both visits discharged directly from ED and hospitalizations using rates of positivity for each virus. During the 2014-2016 winter seasons, 3585 (66%) of the 5412 ARI ED visits were discharged home directly and 1827 (34%) were admitted to hospital. Among visits tested for all respiratory viruses, 601/1111 (54.1%) of ED-only and 639/870 (73.4%) of the hospital-admission groups were positive for at least one respiratory virus. Overall, respiratory virus-associated ED visit rates were almost twice as high as hospitalizations. Respiratory syncytial virus was associated with the highest ED (34.4 per 1000) and hospitalization rates (24.6 per 1000) among infants. ED visit and hospitalization rates varied significantly by age and virus. Māori and Pacific children had significantly higher ED visit and hospitalization rates for all viruses compared with children of other ethnicities. Many infants with acute respiratory virus infections are managed in the ED rather than admitted to the hospital. Higher rates of ED-only versus admitted acute respiratory virus infections occur among infants living in lower socioeconomic households, older infants and infants of Māori or Pacific versus European ethnicity. Respiratory virus infections resulting in ED visits should be included in measurements of ARI disease burden.

Sections du résumé

BACKGROUND
Estimates of the contribution of respiratory viruses to emergency department (ED) utilization remain limited.
METHODS
We conducted surveillance of infants with acute respiratory infection (ARI) associated ED visits, which then resulted in either hospital admission or discharge home. Seasonal rates of specific viruses stratified by age, ethnicity, and socioeconomic status were estimated for both visits discharged directly from ED and hospitalizations using rates of positivity for each virus.
RESULTS
During the 2014-2016 winter seasons, 3585 (66%) of the 5412 ARI ED visits were discharged home directly and 1827 (34%) were admitted to hospital. Among visits tested for all respiratory viruses, 601/1111 (54.1%) of ED-only and 639/870 (73.4%) of the hospital-admission groups were positive for at least one respiratory virus. Overall, respiratory virus-associated ED visit rates were almost twice as high as hospitalizations. Respiratory syncytial virus was associated with the highest ED (34.4 per 1000) and hospitalization rates (24.6 per 1000) among infants. ED visit and hospitalization rates varied significantly by age and virus. Māori and Pacific children had significantly higher ED visit and hospitalization rates for all viruses compared with children of other ethnicities.
CONCLUSIONS
Many infants with acute respiratory virus infections are managed in the ED rather than admitted to the hospital. Higher rates of ED-only versus admitted acute respiratory virus infections occur among infants living in lower socioeconomic households, older infants and infants of Māori or Pacific versus European ethnicity. Respiratory virus infections resulting in ED visits should be included in measurements of ARI disease burden.

Identifiants

pubmed: 32675757
doi: 10.1097/INF.0000000000002681
pii: 00006454-202008000-00010
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e176-e182

Subventions

Organisme : NCIRD CDC HHS
ID : U01 IP000480
Pays : United States

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Auteurs

Namrata Prasad (N)

From the Institute of Environmental Science and Research, Wellington, New Zealand.
Department of Paediatrics, Child & Youth Health, University of Auckland, Auckland, New Zealand.

Adrian A Trenholme (AA)

Kidz First Children's Hospital, Counties Manukau District Health Board, Auckland, New Zealand.

Q Sue Huang (QS)

From the Institute of Environmental Science and Research, Wellington, New Zealand.

Jazmin Duque (J)

School of Population Health, University of Auckland, Auckland, New Zealand.

Cameron C Grant (CC)

Department of Paediatrics, Child & Youth Health, University of Auckland, Auckland, New Zealand.
General Paediatrics, Starship Children's Hospital, Auckland, New Zealand.

E Claire Newbern (EC)

From the Institute of Environmental Science and Research, Wellington, New Zealand.

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