[Children and adolescents in German emergency departments : The most common reasons for presentation throughout the day-current insights from the AKTIN emergency department registry].

Abstract

Background: The planned hospital and emergency care reform in Germany aims, among other things, to restructure emergency services towards integrated emergency centers (INZ) and integrated emergency centers for children and adolescents (KINZ). There is a gap in current data on the reasons for presentation and the use of emergency departments by patients under 18 years of age. This study provides a multicenter analysis of the most common reasons for presentation among children and adolescents in German emergency departments.

Methods: In a retrospective, descriptive cross-sectional analysis, data were collected from 251,570 emergency patients under 18 years of age from January 1, 2019, to June 30, 2022, across 22 emergency departments (including three pediatric emergency departments). Reasons for presentation were categorized according to the Canadian Emergency Department Information System-Presenting Complaint List (CEDIS-PCL) and analyzed by age group, gender, and mode of arrival.

Results: Over 64.1% of children and adolescents presented with one of the ten most common reasons. In pediatric emergency departments, nontrauma-related reasons, such as respiratory infections and abdominal pain, were predominant, while trauma-related reasons were more frequent in general emergency departments. The gender distribution showed a majority of male patients for trauma-related reasons, whereas some nontrauma-related reasons, like abdominal and headache complaints, were more common among females. Most patients (85.5%) arrived at the emergency department independently; only for seizures did ambulance transport prevail. During the day, 67% of patients presented between 06:00 and 18:00, with 33% presenting in the evening and nighttime hours.

Conclusions: The results show that more than half of children and adolescents present to emergency departments with one of the ten most common chief complaints. Notably, nontraumatological presentations in emergency departments (EDs) highlight that pediatric care also takes place in facilities primarily serving adults. In the future, staff and infrastructure should be appropriately equipped to efficiently ensure the quality of pediatric emergency care on a broad scale. An important approach in this regard is health education and the optimization of access to outpatient care structures.