Demographic and Clinical Profile of Visits to the Pediatric Emergency Department of a State Hospital: A 5-Year Retrospective Study

Abstract

Objective: To retrospectively evaluate the demographic and clinical characteristics, presentation timing, diagnosis distribution, hospitalization rates, and 72-hour repeat-visit patterns among patients aged 0 to 17 years presenting to a state hospital pediatric emergency department (PED). Methods: A retrospective cohort study was conducted using electronic health record data from Sinop Atatürk State Hospital (Türkiye) PED between January 1, 2020, and December 31, 2024. A total of 133 880 consecutive patient visits were analyzed. Statistical analyses included descriptive statistics and multivariate logistic regression; robust standard errors and a first-visit sensitivity analysis were applied to account for clustering of repeated visits by the same patient. Results: Of the 133 880 visits analyzed, 53.8% involved male patients, and the mean (SD) age was 7.34 (4.98) years. Upper respiratory tract diseases (ICD-10 codes J06.9, J39.9) were the most common diagnoses, accounting for 37.7% of visits. Presentation volume peaked during the summer season (31.1%) and between 4:00 PM and midnight (48.9%). Respiratory infections predominated in winter, whereas gastrointestinal diagnoses predominated in summer (P < .001). The overall hospitalization rate was 2.6%, rising significantly to 15.0% among infants aged <1 year (P < .001). The 72-hour repeat-visit rate was 6.7% overall, which decreased to 4.7% after excluding follow-up codes (Z00.x). After this adjustment, repeat-visit rates for infants approximated those of other age groups. The crude association between repeat visits and subsequent hospitalization was significant in the full sample (P < .001) but did not persist in the clustering-adjusted sensitivity analysis. Conclusions: Most PED visits did not require hospitalization, exhibiting marked seasonal and diurnal variation. Although the hospitalization rate was significantly higher among infants, unplanned repeat-visit rates were similar across age groups after excluding routine follow-up codes. These findings may inform local health care resource allocation, service capacity optimization, and follow-up planning, particularly for infants and young children.