Eikendal, A.L.M. (2012) Verschil in ernst van ziekzijn tussen verwezen kinderen en zelfverwezen kinderen op Spoedeisende Hulp. thesis, Medicine.
Full text available on request.Abstract
Objective The aim of this study is to assess whether referral of children to the Emergency Department (ED) is associated with greater severity of illness in comparison to self-referrals. Methods A retrospective, crossectional study of data was performed for children who were presented at the ED of the AMC during a five month period with a work diagnosis of one of five in advance determined categories based on organ systems, or who were referred back to the general practitioner cooperative. Data concerning patient demographics, referral status, work diagnosis and treating physician were collected from the electronic medical records and analyzed. Markers for severity of illness that were obtained and analyzed were urgency classification according to the Manchester Triage System, abnormal vital signs at presentation, admittance, length of admittance and whether additional diagnostics were performed. Referred children were compared to self-referred children. Results Of 941 eligible children, 353 (37.5%) were referred and 588 (62.5%) were self-referred. With adjustment for age and gender, referred patients were significantly more likely to be classified as high urgency (P<0.001); to have one or more abnormal vital signs at presentation at the ED (P=0.003); to be admitted (P<0.001); to have additional diagnostics performed (P=0.001) and to have a longer length of admittance (P=0.009) when compared to self-referred patients. However, 42.7% of the self-referrals had an urgent triage category. Conclusions Referral of children to an ED is associated with a higher severity of illness. However, referral status alone is an average predictor to assess severity of illness in children
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Karthaus, Dr. A.J.M. |
| Supervisor name: | Lorijn, Mw. Dr. F. de and Academisch Medisch Centrum Amsterdam and Afdeling: Algemene Pediatrie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/310 |
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