Return Visits in Infants Younger Than 90 Days Presenting to the Pediatric Emergency Department for Fever

Author:

Rogachev Sonia1ORCID,Hashavya Saar1,Rekhtman David1,Schiesel Gali1,Benenson-Weinberg Talia2,Weiser Giora3,Gordon Oren4,Gross Itai1ORCID

Affiliation:

1. Department of Pediatric Emergency Medicine, Hadassah Medical Center, Jerusalem, Israel

2. Department of Pediatrics, Hadassah Medical Center, Jerusalem, Israel

3. Department of Pediatric Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel

4. Infectious Disease Unit, Department of Pediatrics, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel

Abstract

Fever in infants presenting to pediatric emergency departments (PEDs) often results in significant return visits (RVs). This retrospective study aimed to identify factors associated with RVs in febrile infants aged 0 to 90 days. Data from infants presenting to PED between 2018 and 2021 and returning within 7 days (RV group) were compared to age-matched febrile infants without RVs (control group). Each group had 95 infants with similar demographics and medical history. RVs were primarily due to positive cultures and persistent fever. The control group had higher initial hospitalization rates, longer PED stays, and increased antibiotic treatment. Prevalence of serious bacterial infections (SBIs) did not significantly differ. Higher hospitalization, prolonged PED stays, and initial antibiotic treatment were associated with reduced RV incidence despite similar SBI rates. Return visits in infants <90 days were primarily driven by persistent fever and positive cultures. Addressing these factors through targeted parental education and improved care protocols may reduce RVs.

Publisher

SAGE Publications

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