Neonatal presentations to the pediatric emergency department

Abstract

Introduction: To determine the profile of neonatal visits to Trakya University Pediatric Emergency Department (PED).
Material and Method: We conducted a retrospective chart review of all neonates who presented to PED between September 2001 and December 2003. Data gathered from neonatal charts included patient demographics, source of referral, age at presentation, presenting complaint, initial diagnosis, disposition and course in hospital, if admitted.
Results: A total of 434 neonatal visits were identified which accounted for 5.3% of all cases admitting to PED during the same period. Self-referral rate was only 14%. Remainder was referred either by private physicians or by primary and/or secondary care health clinics. Sixty five percent of the cases were male. The most frequent admission time was the first 24 hours of life (28.8%) followed by postnatal third day (8.5%) and fifth day of life (7.6%). The most common presenting complaints were jaundice (39.6%), difficulty breathing (17.5%), and premature birth (11.5%). The most common complaints of the first day admissions were difficulty breathing (36.8%) and premature birth (32%). Hyperbilirubinemia (39%) and respiratory distress (13%) were the most common initial diagnosis. Overall admission rate was 68%. The most frequent reason for hospitalization of the newborns were hyperbilirubinemia (30%), transient tachypnea of the newborn / neonatal pneumonia (18.6%) and disorders related to premature birth (16.2%). Three cases were dead on arrival to the PED.
Conclusion: Our data implies that neonatal presentations to PED represent an important subset of PED visitors. The most common presenting complaints and diagnosis - such as jaundice (39%) - were those which could be solved at primary and secondary care clinics. If those centers could be run more effectively, then the tertiary centers could provide more efficient care to the critical patients such as prematures who may need more sophisticated technical equipment.