Sex differences in febrile children with respiratory symptoms attending European emergency departments: An observational multicenter study

Tan, Chantal D.; El Ouasghiri, Soufiane; Both, Ulrich von; Carrol, Enitan D.; Emonts, Marieke; Flier, Michiel van der; Groot, Ronald de; Herberg, Jethro; Kohlmaier, Benno; Levin, Michael; Lim, Emma; Maconochie, Ian K.; Martinon-Torres, Federico; Nijman, Ruud G.; Pokorn, Marko; Rivero-Calle, Irene; Tsolia, Maria; Vermont, Clementien L.; Zenz, Werner; Zavadska, Dace; Moll, Henriette A. und Zachariasse, Joany M. (2022): Sex differences in febrile children with respiratory symptoms attending European emergency departments: An observational multicenter study.
In: PLOS One 17(8)

Abstract

ObjectiveTo assess sex differences in presentation and management of febrile children with respiratory symptoms attending European Emergency Departments. Design and settingAn observational study in twelve Emergency Departments in eight European countries. PatientsPreviously healthy children aged 0-<18 years with fever (>= 38 degrees C) at the Emergency Department or in the consecutive three days before Emergency Department visit and respiratory symptoms were included. Main outcome measuresThe main outcomes were patient characteristics and management defined as diagnostic tests, treatment and admission. Descriptive statistics were used for patient characteristics and management stratified by sex. Multivariable logistic regression analyses were performed for the association between sex and management with adjustment for age, disease severity and Emergency Department. Additionally, subgroup analyses were performed in children with upper and lower respiratory tract infections and in children below five years. ResultsWe included 19,781 febrile children with respiratory symptoms. The majority were boys (54%), aged 1-5 years (58%) and triaged as low urgent (67%). Girls presented less frequently with tachypnea (15% vs 16%, p = 0.002) and increased work of breathing (8% vs 12%, p<0.001) compared with boys. Girls received less inhalation medication than boys (aOR 0.82, 95% CI 0.74-0.90), but received antibiotic treatment more frequently than boys (aOR 1.09, 95% CI 1.02-1.15), which is associated with a higher prevalence of urinary tract infections. Amongst children with a lower respiratory tract infection and children below five years girls received less inhalation medication than boys (aOR 0.77, 95% CI 0.66-0.89;aOR 0.80, 95% CI 0.72-0.90). ConclusionsSex differences concerning presentation and management are present in previously healthy febrile children with respiratory symptoms presenting to the Emergency Department. Future research should focus on whether these differences are related to clinicians' attitudes, differences in clinical symptoms at the time of presentation and disease severity.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1932-6203
• Sprache: Englisch