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dc.contributor.authorKao, Wei-Tsunen_US
dc.contributor.authorTseng, Yung-Haoen_US
dc.contributor.authorJong, Yuh-Jyhen_US
dc.contributor.authorChen, Tai-Hengen_US
dc.date.accessioned2019-09-02T07:46:12Z-
dc.date.available2019-09-02T07:46:12Z-
dc.date.issued2019-08-01en_US
dc.identifier.issn1875-9572en_US
dc.identifier.urihttp://dx.doi.org/10.1016/j.pedneo.2018.09.008en_US
dc.identifier.urihttp://hdl.handle.net/11536/152602-
dc.description.abstractBackground: No previous studies have explored emergency medical care for children with chronic neuromuscular disorders (NMDs). We aimed to determine the major reasons for the emergency room (ER) readmission of pediatric patients with NMDs and suggest changes to the care plan to decrease readmissions. Methods: Children with chronic NMDs (aged <18 years) who visited a medical center-based ER between January 2005 and January 2015 were included. The following data were extracted from the patient's ER records: presentations; demographic data, including sex and age; NMD diagnosis; triage classification; emergency examination; initial management and outcomes. The outcomes were death inside or outside the ER, admission to the ward or pediatric intensive care unit (PICU), uneventful discharge, and repeated ER visits. Results: In 10 years, 44 children with heterogeneous NMDs (boys/girls: 30/14, mean age: 9.9 years) visited the ER for a total of 204 times. Repeated ER visits and readmissions occurred in 56.8% and 55.6% of the patients, respectively. Most NMD children belonged to triage class 3 (35.3%), with underlying congenital hereditary muscular dystrophy (44.1%). The major symptoms were usually multiple and concurrent, and primarily respiratory (62.3%) or gastrointestinal (28.9%). The most common causes of hospitalization were pneumonia (48.5%) or acute gastritis (20.4%), and approximately half of the ER visits required further hospitalization, of which 28.2% involved PICU admission. Twenty of the 36 children admitted to the ER required readmission. The most commonly prescribed examinations were complete blood count (38%) and C-reactive protein (38%), and the most common therapy was intravenous fluid administration (34%). Although respiratory compromise caused most ER visits and admissions, pulmonary assessments, including chest films (28%), pulse oximetry (15%), and blood gas analysis (11%), were performed in a relatively small proportion. Conclusion: The ER staff must recognize patients' unmet needs for respiratory and gastrointestinal care related to underlying NMDs. Copyright (C) 2018, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC.en_US
dc.language.isoen_USen_US
dc.subjectemergency roomen_US
dc.subjectneuromuscular disordersen_US
dc.subjectpediatricsen_US
dc.subjectrespiratory failureen_US
dc.titleEmergency room visits and admission rates of children with neuromuscular disorders: A 10-year experience in a medical center in Taiwanen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.pedneo.2018.09.008en_US
dc.identifier.journalPEDIATRICS AND NEONATOLOGYen_US
dc.citation.volume60en_US
dc.citation.issue4en_US
dc.citation.spage405en_US
dc.citation.epage410en_US
dc.contributor.department交大名義發表zh_TW
dc.contributor.departmentNational Chiao Tung Universityen_US
dc.identifier.wosnumberWOS:000480419100009en_US
dc.citation.woscount0en_US
Appears in Collections:Articles