Hospital course of croup after emergency department management

Anna Sofi Asmundsson, Joseph Arms, Rahul Kaila, Mark G. Roback, Carly Theiler, Cynthia S. Davey, Jeffrey P. Louie

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

OBJECTIVES: To describe inpatient management of patients with croup admitted from the emergency department (ED). METHODS: In a multicentered, cross-sectional observational study based on retrospective chart review, we identified children 6 months to 5 years of age with a discharge diagnosis of croup. All patients were evaluated in the ED and treated with at least 1 dose of racemic epinephrine (RE) before admission. Children with hypoxia or directly admitted to the PICU were excluded. RESULTS: We identified 628 admissions for croup. Significant interventions, defined as additional RE, helium-oxygen use, or PICU transfer, occurred in 142 patients (22.6%). A total of 137 children received additional RE on the inpatient ward, and 5 received RE and were transferred to the PICU. No patient was treated with helium-oxygen. A total 486 (77.4%) of patients did not receive significant interventions postadmission. Length of stay for children not requiring significant intervention was, on average,,24 hours (18.8 hours [SD 9.3]; range 1.2–111 hours). Children with tachypnea (odds ratio 5 2.5; P 5 .002) on arrival to ED and patients who had ED radiographs (odds ratio 5 1.7; P 5 .018) had increased odds of receiving a significant intervention after admission. CONCLUSIONS: Less than one-quarter of children admitted to the general wards for croup received significant interventions after admission. Tachypnea in the ED and use of radiograph were associated with an increased use of significant interventions.

Original languageEnglish (US)
Pages (from-to)326-332
Number of pages7
JournalHospital Pediatrics
Volume9
Issue number5
DOIs
StatePublished - May 2019

Bibliographical note

Publisher Copyright:
Copyright © 2019 by the American Academy of Pediatrics.

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