Pediatric Patients with Intracranial Arteriovenous Malformations: Trends in Emergency Room Presentation.

BACKGROUND

Pediatric intracranial arteriovenous malformation (AVM) patients are commonly admitted to the emergency room (ER). Increasing patient utilization of the ER has been associated with healthcare disparities and a trend of decreased efficiency. Correspondingly, the aim of this study was to evaluate the trends of pediatric AVM ER admissions over recent years and identify factors associated with health care resource utilization and outcomes.

METHODS

The 2016-2019 National Inpatient Sample (NIS) was queried for patients under the age of 18 admitted with AVM. Cases of admission through the ER were identified. Demographic and severity factors associated with ER admission were explored using comparative and regression statistics.

RESULTS

Of 3,875 pediatric patients with AVM admitted between 2016-2019, 1,280 (33.0%) were admitted via the ER. Patients admitted via the ER were more likely to be in the lowest median income category (p < 0.001), on Medicaid insurance (p = 0.008), or in the South (p < 0.001) than patients admitted otherwise. There was increased severity and increased rates of intracranial hemorrhage (ICH) in patients admitted via the ER (p < 0.001). Finally, there were increasing trends in ER admission and ICH throughout the years.

CONCLUSION

ER admission of pediatric AVM patients with ICH is increasing and is associated with a distinct socioeconomic profile and increased healthcare resource utilization. These findings may reflect decreased access to more advanced diagnostic modalities, primary care, and other important resources. Identifying populations with barriers to care is likely an important component to policy aimed at decreasing the risk of severe disease presentation.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.