TY - JOUR
T1 - Sex differences in febrile children with respiratory symptoms attending European emergency departments
T2 - An observational multicenter study
AU - Tan, Chantal D.
AU - el Ouasghiri, Soufiane
AU - von Both, Ulrich
AU - Carrol, Enitan D.
AU - Emonts, Marieke
AU - van der Flier, Michiel
AU - de Groot, Ronald
AU - Herberg, Jethro
AU - Kohlmaier, Benno
AU - Levin, Michael
AU - Lim, Emma
AU - Maconochie, Ian K.
AU - Martinon-Torres, Federico
AU - Nijman, Ruud G.
AU - Pokorn, Marko
AU - Rivero-Calle, Irene
AU - Tsolia, Maria
AU - Vermont, Clementien L.
AU - Zenz, Werner
AU - Zavadska, Dace
AU - Moll, Henriette A.
AU - Zachariasse, Joany M.
N1 - Publisher Copyright: © 2022 Tan et al.
PY - 2022/8/3
Y1 - 2022/8/3
N2 - Objective To assess sex differences in presentation and management of febrile children with respiratory symptoms attending European Emergency Departments. Design and setting An observational study in twelve Emergency Departments in eight European countries. Patients Previously healthy children aged 0-<18 years with fever (≥ 38°C) at the Emergency Department or in the consecutive three days before Emergency Department visit and respiratory symptoms were included. Main outcome measures The 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. Results We 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). Conclusions Sex 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.
AB - Objective To assess sex differences in presentation and management of febrile children with respiratory symptoms attending European Emergency Departments. Design and setting An observational study in twelve Emergency Departments in eight European countries. Patients Previously healthy children aged 0-<18 years with fever (≥ 38°C) at the Emergency Department or in the consecutive three days before Emergency Department visit and respiratory symptoms were included. Main outcome measures The 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. Results We 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). Conclusions Sex 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.
UR - http://www.scopus.com/inward/record.url?scp=85135453221&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0271934
DO - 10.1371/journal.pone.0271934
M3 - Article
C2 - 35921337
AN - SCOPUS:85135453221
SN - 1932-6203
VL - 17
JO - PLoS ONE
JF - PLoS ONE
IS - 8 August
M1 - e0271934
ER -