Emergency department utilization among pediatric spina bifida patients.
Stefanie Riddle, Jareen Meinzen-Derr, Meredith Tabangin and 2 others
PMID 31744029WHAT IT FOUND
Children with spina bifida, especially those with higher lesion levels, used the emergency department frequently.
Shunt concerns drove most visits, but only 10% of those with shunt complaints had a malfunction. Urinary issues were the most common reason for hospital admission.
Key findings
01Shunt-related chief complaints accounted for 52% of visits, yet only 10% of these resulted in a diagnosis of shunt malfunction.
02Genitourinary diagnoses were the largest organ-specific category and led to admission in 49% of visits.
03Patients with higher lesion levels were significantly more likely to utilize the emergency department.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a single-center study, so the results may not apply to hospitals with different patient populations or care structures. The researchers relied on ICD-9 codes, which can be inaccurate or miss diagnoses not pertinent to the specific visit. The study could not account for clinical decision-making, such as distinguishing between a symptomatic urinary tract infection and asymptomatic colonization. Information about visits to other institutions or primary care providers was not available, so total emergency utilization might be underestimated.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not assume that a child presenting with shunt-related symptoms has a shunt malfunction. Only 10% of visits with a shunt-related chief complaint resulted in a diagnosis of shunt malfunction, meaning most visits were for other reasons.