Open AccessEmergency Department Chief Complaints Among Children With Cancer
Author(s) -
Megan D Burcham,
Anneli R Cochrane,
Seethal A. Jacob,
Aaron E. Carroll,
Emily L. Mueller
Publication year - 2018
Publication title -
journal of pediatric hematology/oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.388
H-Index - 78
eISSN - 1536-3678
pISSN - 1077-4114
DOI - 10.1097/mph.0000000000001223
Subject(s) - medicine , emergency department , odds ratio , nausea , vomiting , confidence interval , logistic regression , pediatrics , medical record , psychiatry
Children with cancer have high emergency department (ED) utilization, but little is known about their chief complaints. A retrospective chart review of ED chief complaints for children with cancer (actively receiving therapy) at Riley Hospital for Children from January 2014 to December 2015 was performed. Proportions of visits and disposition for top 5 chief complaints were determined. Multivariate logistic regression analyzed factors associated with admission. There were 598 encounters by 231 children with cancer. About half (49%) had >1 complaint. The 5 most common primary chief complaints were: fever (60.2%), pain (6.5%), nausea/vomiting (5.0%), bleeding (3.9%), and abnormal laboratory values (3.3%). Admission rates varied, with the highest rates being for nausea/vomiting (66.7%). Risk factors for admission were: hospitalization in prior 4 weeks (odds ratio [OR], 2.67; confidence interval [CI], 1.77-4.02), chief complaint of fever (OR, 1.90; CI, 1.16-3.09). For each increase in number of chief complaints, odds increased by 1.45 (CI, 1.14-1.83). Black, non-Hispanic (OR, 0.44; CI, 0.22-0.88) as compared with white, non-Hispanic, younger age (OR, 0.53; CI, 0.29-0.99) or complaint of abnormal laboratory values (OR, 0.20; CI, 0.06-0.68) had lower odds of admission. Children with cancer present to the ED with multiple and varied complaints. Future interventions could aim to improve caregiver anticipatory guidance and ED visit preparedness.