Unexpected readmissions after discharge of short term stay unit of a pediatric emergency room in Viseu, Portugal <b>[Abstract in English]</b>

Abstract

Aims: The aim of this study was to evaluate different clinical aspects in a short term stay unit of the emergency room of São Teotónio’s Hospital, Viseu, Portugal, with emphasis on the evolution of the cases that have returned to the emergency room, within 72 hours after discharge. Methods: Medical records of children discharged from this unit that returned to the emergency room on the following 72 hours, in a 12 months period, were reviewed. We have analyzed the initial diagnosis and those made on readmission. Results: In 2005, 33,211 children/adolescents were registered in the emergency room, and 1,395 (4.2%) were admitted in the short term stay unit. From this sample, 70 out of 905 discharges (7.7%) returned unexpectedly to the emergency room on the following 72 hours. The leading causes of these returns were urinary tract infection, acute gastroenteritis and fever, more frequently in children younger than two years of age. From this group of 70 children, 21.4% needed readmission in the unit, and 10% had a new diagnosis of important clinical meaning. One patient had an intestinal occlusion that required surgical intervention. Conclusions: These data are helpful in identifying some of the issues of pediatric readmissions, in order to implement new strategies to improve the clinical approach of this group of patients.