Clinical Profile and Risk Factors Associated in Global Developmental Delay Children at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia
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Date
2025-02-10
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Addis Ababa University
Abstract
Background: The length of stay in pediatric emergency departments (PED) is a critical factor in providing timely and efficient care to children in need of immediate medical attention. Various factors, including operational, clinical, and social elements, influence the duration of stay in these departments. Research has shown that the introduction of dedicated pediatric emergency rooms can help reduce the average length of stay, despite an increase in patient volume (2). Additionally, family characteristics, such as primary language spoken at home, socioeconomic status, and insurance status, also play a role in determining the length of stay (7). Resource constraints in healthcare settings, such as limited availability of diagnostic tools and pediatric specialists, can further complicate these factors, potentially leading to longer wait times and lengths of stay (1).
Objective: This study aimed to examine the length of stay and the various factors influencing this duration in the Pediatrics Emergency Unit at Tikur Anbessa Specialized Hospital from September 11 to November 9, 2024.
Methods: Hospital-based cross-sectional study was employed from September 11 to November 9, 2024 G.C. at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 302 selected patients were studied. Data were collected by using a standard checklist through google sheet and analyzed using SPSS version 27 software package. Mean, and standard deviation were used to describe Continuous data; and frequency and percentage were used to describe categorical data. To identify factors associated with Pediatrics emergency department length of stay. Bivariable and Multivariable binary logistic regression analyses were done. Statistical significance was considered at level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association.
Result: The prevalence of prolonged stays in the pediatric emergency department was found to be 84.4% (255); 95% CI: 79.8 - 88.3%. seeking care for Surgical reasons 0.16[0.06-0.43], who had no prior treatment 0.45[0.22-0.95], comatose mental status 0.09[0.01-0.64], illness duration longer than 24 hours 4.6[2.11-10.2],Investigation ordered 14[2.19-98.7], two/more investigation ordered 19.2[1.5-236.6], surgical intervention P age 5 | 43 preformed 0.14[0.02-0.81], observation as an intervention 0.11[0.02-0.48], Delays in diagnostic services 0.17[0.06-0.47], Staff shortages 0.034[0.005-0.23] and not dedicated staff 4.12[1.49-11.3] were significantly associated with Pediatrics emergency departments length of stay.
Conclusion: The study found that the prevalence of prolonged stays in the pediatric emergency department at Tikur Anbessa Specialized Hospital was high (84.4%). Several factors were significantly associated with length of stay, including clinical, operational, and resource-related elements. Patients with illness durations exceeding 24 hours, those requiring investigations, and those needing multiple investigations were more likely to experience prolonged stays, while surgical intervention and observation were associated with shorter stays. Additionally, the absence of prior treatment, comatose mental status, and delays in diagnostic services contributed to longer stays. Resource limitations, such as staff shortages and lack of dedicated staff, were also significant factors. Addressing these challenges through improved resource allocation, timely diagnostics, and staff management may help reduce prolonged stays and enhance pediatric emergency care efficiency.
Key words: Pediatrics emergency department length of stay, TASH, Pediatric Emergency Unit, factors
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Pediatric patient neurodevelopment clinic risk factor