Emergency department use by infants less than 14 days of age.
OBJECTIVE
To determine the factors associated with nonacute presentation to the emergency department (ED) by infants less than 14 days of age.


METHODS
A prospective survey was conducted in the pediatric ED of a teaching hospital providing voluntary in-home follow-up for families discharged within 48 hours of delivery. Participants were families of infants less than 14 days of age presenting to the ED over a 1-year period. The main outcome measure was acuteness of presenting problem. Presenting problems were classified as nonacute if the following 4 criteria were met: (i) no physician referral; (ii) nonurgent triage code assigned by a triage nurse; (iii) no investigations performed in the ED; and (iv) discharge home.


RESULTS
Of the 142 eligible infants, 70 (49%) infants presented with nonacute problems. Ninety-two (65%) returned questionnaires. There was no significant difference in the proportion of nonacute problems between infants discharged at less than 48 hours of age and those discharged at more than 48 hours (P = 0.7). The proportion of nonacute problems among infants of primiparous mothers was significantly higher (64%) than among infants of multiparous mothers (24%) (P < 0.001). Infants of mothers less than 25 years of age were more likely to present with nonacute problems (P = 0.002).


CONCLUSIONS
Primiparity and maternal age less than 25 years were associated with nonacute ED presentation. Acuteness of presentation to the ED was not influenced by timing of neonatal discharge. Therefore, perinatal education might be best targeted at first time mothers and young mothers to reduce the number of nonacute ED visits.
Kennedy
T J T
TJ
Department of Pediatrics, Dalhousie University and IWK Grace Health Centre, Halifax, Nova Scotia.
Purcell
L K
LK
LeBlanc
J C
JC
Jangaard
K A
KA
D000293:Adolescent; D000328:Adult; D001722:Birth Order; D003953:Diagnosis-Related Groups; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D009035:Mothers / Q000523:psychology; D009674:Nova Scotia / Q000453:epidemiology; D010298:Parity; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors