Rachel L Wattier, Daniel J Shapiro, Hillary L Copp, Sunitha V Kaiser, Adam L Hersh
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引用次数: 0
Abstract
Objective: To evaluate the extent of and factors associated with urine testing in US pediatric ambulatory visits for symptoms commonly associated with viral illness.
Study design: We analyzed a nationally representative, cross-sectional sample of ambulatory clinic and emergency department (ED) visits among children 2 months to 17 years old (2014 through 2019 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey). Using reason for visit classification codes, we identified visits for respiratory symptoms, diarrhea, or rash; termed "viral symptoms" without reported localizing genitourinary symptoms. We assessed the proportion of these visits with urine testing (urinalysis and/or urine culture) and evaluated factors associated with urine testing using logistic regression.
Results: Of 71.3 million (95% CI 64.7-78.0 million) pediatric ambulatory visits per year, 61% (95% CI 59-63%) were for viral symptoms without reported genitourinary symptoms. Urine testing at these visits accounted for 38% (95% CI 30-47%) of overall urine testing. Such testing occurred more frequently at ED visits (8.3%; 95% CI 7.4-9.3%) compared with clinic visits (4.4%; 95% CI 2.5-7.7%). At ED visits, the adjusted probability of urine testing in the context of viral symptoms was lowest for males age 2 months to <2 years (5%; 95% CI 3-6%) and highest for females age 12 through 17 years (20%; 95% CI 16-24%), and females age 6-11 years (13%; 95% CI 11-16%).
Conclusions: Urine testing in children with symptoms of viral or other non-UTI illnesses occurs frequently at ambulatory visits. This potentially avoidable testing disproportionately occurred in older age groups with low clinical risk of UTI.
期刊介绍:
The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy.
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