Management Patterns of Croup in Korean Emergency Departments: A Nationwide Cohort Study
Abstract
Highlights What are the main findings? Despite guideline recommendations, only around half of children with croup in Korean emergency departments received corticosteroids. Dedicated pediatric emergency centers (DPECs) were associated with lower use of potentially low-value interventions (salbutamol and chest and cervical radiography) than general emergency centers (GECs). What is the implication of the main finding? Education and implementation of standardized national clinical guidelines are needed to optimize croup management in Korean emergency departments. Abstract Background: Despite the established importance of prescribing steroids to children with croup, many physicians in Korean emergency departments (EDs) do not adhere to this recommendation. This study aimed to evaluate treatment appropriateness by investigating steroid prescription rates and potentially low-value interventions such as salbutamol nebulizers and radiographs and to compare dedicated pediatric emergency centers (DPECs) and general emergency centers (GECs) to understand treatment trends for croup in Korea. Methods: This retrospective cohort study analyzed a 5% random sample of the National Health Screening Program for Infants and Children (NHSPIC) cohort linked to the National Health Insurance Service database (2008–2015). The study included children with a primary diagnosis of croup and excluded children who were prescribed oral or steroid injections within three days before their ED visit. The…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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