Emergency department presentations in infants: Predictors from an Australian birth cohort: Predicting emergency department presentation in infants
2017
Aim: Infants under 12 months of age are disproportionately represented amongst emergency department (ED) presentations, and infants are
more likely to be frequent ED users. This study aimed to describe and identify psychosocial predictors of ED presentation in infants.
Methods: A prospective birth cohort from Queensland and New South Wales (Environments for Healthy Living) was used to understand infant
health service use. Baseline and 12-month questionnaire data pertaining to children born between 2006 and 2011 were used to identify predictors
of ED presentation, using multiple regression analysis.
Results: Of the 2184 children in the cohort with available baseline and 12-month data, 579 (27%) presented at least once to an ED during their
first 12 months of life. Statistically significant predictors of ED presentation in the multivariate analysis included the mother having asthma (odds
ratio (OR) 1.67, 95% confidence interval (CI) 1.15–2.39) and a higher Kessler-6 score (a measure of psychological distress) of the primary carer at
baseline (OR 1.04, 95% CI 1.01–1.08). Maternal education level was not associated with ED presentations of infants.
Conclusions: This study describes maternal and child factors of children who present to the ED in the first year of life. Factors related to an
infant’s support system were found to be predictors for an ED presentation in the first year of life. This study emphasises the need to review the
maternal medical history and psychosocial situation. There may be benefits for health-care practitioners to take the opportunity (such as during
routine childhood immunisation) to perform a brief screening tool (such as the Kessler-6) to understand psychological distress experienced by
mothers. This may influence the likelihood of a child presenting to an ED within the first 12 months of life.
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