Oral Presentation Australian Epidemiology Association ASM 2018

Emergency department burden of acute respiratory infections and risk factors (#15)

Rosanne Barnes 1 , Christopher C Blyth 2 3 4 , Nicholas de Klerk 5 , Weihao Lee 6 , Meredith L Borland 6 , Peter Richmond 2 7 , Faye J Lim 5 , Parveen Fathima 1 , Hannah C Moore 1
  1. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
  2. Division of Paediatrics, School of Medicine, The University of Western Australia, Crawley, WA, Australia
  3. Department of Infectious Diseases, Princess Margaret Hospital for Children, Subiaco, WA, Australia
  4. Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, WA, Australia
  5. Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
  6. Emergency Department, Princess Margaret Hospital for Children, Subiaco, WA, Australia
  7. Princess Margaret Hospital for Children, Subiaco, WA, Australia

Introduction Studies examining Acute Respiratory Infections (ARIs) in Emergency Departments (EDs), particularly in rural and remote areas, are rare. This study aimed to examine the burden of ARIs among Aboriginal and non-Aboriginal children presenting to Western Australian (WA) EDs from 2002 to 2012.

Method Using a retrospective population-based cohort study linking ED records to birth and perinatal records, we examined presentation rates for metropolitan, rural and remote Aboriginal and non-Aboriginal children from 469,589 births. We used ED diagnosis information to categorise presentations into ARI groups and calculated age-specific rates. Negative binomial regression was used to investigate association between risk factors and frequency of ARI presentation.

Results Overall 26% of presentations were for ARIs. For Aboriginal children, the highest rates were for those aged <12 months in the Great Southern (1,233 per 1,000 child-years) and Pilbara regions (1,088 per 1,000 child-years). Rates for non-Aboriginal children were highest in children <12 months in the Southwest and Kimberley (400 and 375 per 1,000 child-years respectively). Presentation rates for ARI in children from rural and remote WA significantly increased over time in children aged <5 years. Risk factors for presenting to ED with ARI in Aboriginal and non-Aboriginal children were: male, prematurity, Caesarean delivery, and residence in the Kimberley and lower socio-economic areas.

Conclusion One-in-four ED presentations in WA children are for ARIs, representing a significant out-of-hospital burden with some evidence of geographical disparity. Planned linkages with hospital discharge diagnosis data will aid in assessing the sensitivity and specificity of ARI diagnoses in EDs.