View in EDS

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

Saved in:
Bibliographic Details
Title: Clinical Characteristics and Resource Utilization in Children Presenting to the Pediatric Emergency Department With Neck Swelling
Authors: Sofia S. Cook, Breahn F. Donaldson, Pradip P. Chaudhari, Phung K. Pham, Deborah R. Liu
Source: Pediatric Emergency Care. 41:790-795
Publisher Information: Ovid Technologies (Wolters Kluwer Health), 2025.
Publication Year: 2025
Description: 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.
Document Type: Article
Language: English
ISSN: 1535-1815
0749-5161
DOI: 10.1097/pec.0000000000003433
Accession Number: edsair.doi...........b7e1659daeed5c32f0d672ac261d1f03
Database: OpenAIRE
Description
Abstract: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