Pediatric abscess characteristics associated with hospital admission from the ED.
OBJECTIVE
To determine the characteristics of pediatric soft tissue abscesses that result in hospital admission.


METHODS
All visits for soft tissue abscesses to the study emergency department (ED) were examined during 2008. Detailed records were reviewed to determine ED disposition, abscess size, location, presence of fever, duration of symptoms, previous antibiotic therapy, prior ED visit(s), and wound and blood culture results. Data were analyzed to determine which of these characteristics were associated with hospital admission from the ED.


RESULTS
Six hundred twenty-two patients met the inclusion criteria. One hundred thirteen (18%) patients were admitted to the hospital and 509 (82%) were discharged home. Compared to those sent home, abscesses resulting in admission were more likely to be located in the genital area (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.37-6.90), breast (OR, 4.8; 95% CI, 1.08-21.4), or face (OR, 4.39; 95% CI, 1.86-10.3), and were more likely to be larger than 3 cm (OR, 3.66, 95% CI, 2.10-6.36). Patients who were admitted to the hospital were also more likely to have fever (OR, 5.93; 95% CI, 3.4-10.3) and have had a prior ED visit with the same complaint (OR, 3.81; 95% CI, 1.77-8.2). Seventy-seven percent of abscesses that were cultured were positive for methicillin-resistant Staphylococcus aureus.


CONCLUSIONS
Size and location (especially those in the genital region, breast, and face), appear to be associated with admission for pediatric abscesses. History of fever and previous ED visit also appear to be associated with hospital admission. Obtaining blood cultures for pediatric abscesses is likely of little clinical benefit.
Sauer
Michael W
MW
Department of Pediatrics, Emory University, Atlanta, GA 30303, USA. mwsauer@emory.edu
Hirsh
Daniel A
DA
Simon
Harold K
HK
Kharazmi
Shervin A
SA
Sturm
Jesse J
JJ
D000038:Abscess / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000209:etiology; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy
D000900:Anti-Bacterial Agents