{"title":"Implementation of a “hypoglycemia kit” in a pediatric emergency room: A retrospective study during 2011–2019","authors":"Faustine Dulion , Franklin Ducatez , Abdellah Tebani , Bénédicte Sudrié-Arnaud , Matthieu Côme , Maude Auger , Stéphane Marret , Soumeya Bekri","doi":"10.1016/j.arcped.2023.09.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>Hypoglycemia is a common symptom in pediatrics<span> that can lead to neurological sequelae. The etiologies are mostly benign, but hypoglycemia can be a symptom of severe underlying disease. To streamline the etiological investigations, a “hypoglycemia kit,” containing supplies needed to perform specific analyses quickly, was made available in the pediatric </span></span>emergency department of the Rouen University Hospital in 2011. Since its introduction, this kit has been used to explore all cases of hypoglycemia regardless of the context. However, although very useful, these analyses are expensive. The objective of our study was to examine the cost-effectiveness of this kit and to refine its indications if necessary.</p></div><div><h3>Methods</h3><p>This was a non-interventional and retrospective single-center study. Digital records of patients for whom a hypoglycemia kit was used from September 2011 to August 2019 at the pediatric emergency department of Rouen University Hospital were used to retrieve clinical characteristics, laboratory results, and the causes of hypoglycemia.</p></div><div><h3>Results</h3><p>The study included 82 patients. The etiologic investigation concluded that 74 patients had functional hypoglycemia, and eight cases were attributed to other etiologies. In two cases, the kit led to a diagnosis, i.e., 2.4 % efficiency. A history of congenital malformations or previous hypoglycemia was significantly associated with severe etiologies. However, there was no significant association between hypoglycemia severity, age, sex, and these etiologies.</p></div><div><h3>Conclusion</h3><p>Our study reveals that the cost-effectiveness of the hypoglycemia kit is low in pediatric emergencies (2.4 %) at Rouen University Hospital, where functional hypoglycemia remains the leading cause of hypoglycemia. However, our results allow us to suggest a decision tree for refining the usability of this kit, which would considerably increase its efficiency.</p></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives De Pediatrie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0929693X23001732","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Hypoglycemia is a common symptom in pediatrics that can lead to neurological sequelae. The etiologies are mostly benign, but hypoglycemia can be a symptom of severe underlying disease. To streamline the etiological investigations, a “hypoglycemia kit,” containing supplies needed to perform specific analyses quickly, was made available in the pediatric emergency department of the Rouen University Hospital in 2011. Since its introduction, this kit has been used to explore all cases of hypoglycemia regardless of the context. However, although very useful, these analyses are expensive. The objective of our study was to examine the cost-effectiveness of this kit and to refine its indications if necessary.
Methods
This was a non-interventional and retrospective single-center study. Digital records of patients for whom a hypoglycemia kit was used from September 2011 to August 2019 at the pediatric emergency department of Rouen University Hospital were used to retrieve clinical characteristics, laboratory results, and the causes of hypoglycemia.
Results
The study included 82 patients. The etiologic investigation concluded that 74 patients had functional hypoglycemia, and eight cases were attributed to other etiologies. In two cases, the kit led to a diagnosis, i.e., 2.4 % efficiency. A history of congenital malformations or previous hypoglycemia was significantly associated with severe etiologies. However, there was no significant association between hypoglycemia severity, age, sex, and these etiologies.
Conclusion
Our study reveals that the cost-effectiveness of the hypoglycemia kit is low in pediatric emergencies (2.4 %) at Rouen University Hospital, where functional hypoglycemia remains the leading cause of hypoglycemia. However, our results allow us to suggest a decision tree for refining the usability of this kit, which would considerably increase its efficiency.
简介:低血糖是儿科常见的症状,可导致神经系统后遗症。病因大多是良性的,但低血糖可能是严重潜在疾病的症状。为了简化病因调查,2011年,鲁昂大学医院(Rouen University Hospital)的儿科急诊科提供了一种“低血糖试剂盒”,其中包含快速进行特定分析所需的用品。自推出以来,该试剂盒已被用于探索所有低血糖病例,无论背景如何。然而,尽管这些分析非常有用,但代价昂贵。我们研究的目的是检查该试剂盒的成本效益,并在必要时改进其适应症。方法:这是一项非干预性、回顾性的单中心研究。使用2011年9月至2019年8月在鲁昂大学医院儿科急诊科使用降糖试剂盒的患者的数字记录来检索临床特征、实验室结果和低血糖的原因。结果:纳入82例患者。病因学调查得出74例患者有功能性低血糖,8例归因于其他病因。在两个病例中,该试剂盒的诊断效率为2.4%。先天性畸形史或既往低血糖与严重病因显著相关。然而,低血糖严重程度、年龄、性别和这些病因之间没有显著关联。结论:我们的研究表明,在鲁昂大学医院的儿科急诊中,降糖试剂盒的成本效益很低(2.4%),在那里,功能性低血糖仍然是低血糖的主要原因。然而,我们的结果允许我们建议一个决策树来改进这个工具包的可用性,这将大大提高它的效率。
期刊介绍:
Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics.
Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues.
All manuscripts submitted to the journal are subjected to peer review by international experts, and must:
Be written in excellent English, clear and easy to understand, precise and concise;
Bring new, interesting, valid information - and improve clinical care or guide future research;
Be solely the work of the author(s) stated;
Not have been previously published elsewhere and not be under consideration by another journal;
Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed.
Under no circumstances does the journal guarantee publication before the editorial board makes its final decision.
Archives de Pédiatrie is the official publication of the French Society of Pediatrics.