Pediatric and Adolescent Obstetric & Gynecologic Encounters in U.S. Emergency Rooms: A Cross Sectional Study
Abstract
Study Objective: To describe pediatric and adolescent obstetric and gynecologic diagnoses presenting at emergency departments (EDs) in the United States. Methods: This was a retrospective cross-sectional study design utilizing the Nationwide Emergency Department Sample (NEDS) comprising of hospital owned EDs throughout the United States in 2018. Participants included a sample set of female patients from birth to 18 years old. All obstetric and gynecologic (OB/GYN) ICD-10 (International Classification of Diseases) codes were categorized. Descriptive, bivariate, and multivariate analyses assessed diagnoses by age group, hospital type, ED disposition (e.g., admission and transfer), payor, and median household income. Results: In 2018, there were 518,244 OB/GYN ED visits in female patients less than or equal to 18 years of age. Vulvovaginal disorders and abnormal uterine bleeding were both top five presentations in all age groups. Top diagnoses varied by age group. Diagnoses with higher morbidity and mortality (ovarian torsion and ectopic pregnancy) had higher admission and transfer rates compared to diagnoses that can commonly be managed outpatient (vulvar/vaginal disorders). Conclusions: This is the first study evaluating OB/GYN diagnoses among pediatric and adolescent patients presenting to the ED. Educational and referral efforts should focus not only on emergent diagnoses such as ovarian torsion, adnexal masses, and ectopic pregnancy, but also on common presentations that…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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