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Clinical Characteristics and Resource Utilization in Children Presenting to the Pediatric Emergency Department With Neck Swelling

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Název: Clinical Characteristics and Resource Utilization in Children Presenting to the Pediatric Emergency Department With Neck Swelling
Autoři: Sofia S. Cook, Breahn F. Donaldson, Pradip P. Chaudhari, Phung K. Pham, Deborah R. Liu
Zdroj: Pediatric Emergency Care. 41:790-795
Informace o vydavateli: Ovid Technologies (Wolters Kluwer Health), 2025.
Rok vydání: 2025
Popis: Objectives: We aimed to describe patient characteristics, diagnostic imaging rates, and resource utilization in children presenting to the emergency department (ED) with neck swelling. Methods: We conducted a single-center retrospective cross-sectional chart review study of children Results: We studied 680 ED encounters with neck swelling, 32.4% (n=220) of which involved imaging. When imaging was ordered, ultrasound, computed tomography, or plain film radiography was ordered in 79% (n=180), 18.4% (n=43), and 4.7% (n=11) of encounters, respectively. Patients with fever (OR: 1.55, 95% CI: 1.11, 2.15), recent antibiotic use (OR: 1.8, 95% CI: 1.25, 2.6), and neck tenderness on physical examination (OR: 3.01, 95% CI: 2.11, 4.3) had increased odds of undergoing imaging. A subanalysis demonstrated that 15.4% (n=37) of patients with reactive lymphadenopathy and 32.9% (n=71) of patients with adenitis were imaged, despite over 95% of these patients being discharged home. Among all patients discharged home (n=570), median [IQR] ED length of stay was 3.6 [2.7, 5.4] hours in encounters with imaging and 1.9 [1.1, 3.4] hours in encounters without imaging (OR: 1.4; 95% CI: 1.3-1.5). Conclusions: Historical characteristics and physical examination findings vary among children presenting to the ED with neck swelling, including among those who undergo imaging. Children diagnosed with reactive lymphadenopathy and adenitis are typically discharged home from the ED, whether or not imaging was performed, suggesting that imaging may not always be necessary in these patients. Future studies are needed to understand which presenting signs and symptoms should lead to neck imaging and which imaging modality is best.
Druh dokumentu: Article
Jazyk: English
ISSN: 1535-1815
0749-5161
DOI: 10.1097/pec.0000000000003433
Přístupové číslo: edsair.doi...........b7e1659daeed5c32f0d672ac261d1f03
Databáze: OpenAIRE
Popis
Abstrakt:Objectives: We aimed to describe patient characteristics, diagnostic imaging rates, and resource utilization in children presenting to the emergency department (ED) with neck swelling. Methods: We conducted a single-center retrospective cross-sectional chart review study of children Results: We studied 680 ED encounters with neck swelling, 32.4% (n=220) of which involved imaging. When imaging was ordered, ultrasound, computed tomography, or plain film radiography was ordered in 79% (n=180), 18.4% (n=43), and 4.7% (n=11) of encounters, respectively. Patients with fever (OR: 1.55, 95% CI: 1.11, 2.15), recent antibiotic use (OR: 1.8, 95% CI: 1.25, 2.6), and neck tenderness on physical examination (OR: 3.01, 95% CI: 2.11, 4.3) had increased odds of undergoing imaging. A subanalysis demonstrated that 15.4% (n=37) of patients with reactive lymphadenopathy and 32.9% (n=71) of patients with adenitis were imaged, despite over 95% of these patients being discharged home. Among all patients discharged home (n=570), median [IQR] ED length of stay was 3.6 [2.7, 5.4] hours in encounters with imaging and 1.9 [1.1, 3.4] hours in encounters without imaging (OR: 1.4; 95% CI: 1.3-1.5). Conclusions: Historical characteristics and physical examination findings vary among children presenting to the ED with neck swelling, including among those who undergo imaging. Children diagnosed with reactive lymphadenopathy and adenitis are typically discharged home from the ED, whether or not imaging was performed, suggesting that imaging may not always be necessary in these patients. Future studies are needed to understand which presenting signs and symptoms should lead to neck imaging and which imaging modality is best.
ISSN:15351815
07495161
DOI:10.1097/pec.0000000000003433