Intent, Substance, and Care: Characteristics of Adolescent Ingestion Hospitalizations. Hosp Pediatr 2021 Feb;11(2):160-166
Date
01/21/2021Pubmed ID
33468552DOI
10.1542/hpeds.2020-0083Scopus ID
2-s2.0-85149108940 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
OBJECTIVES: To characterize the patient population of adolescents hospitalized at a tertiary center for ingestions and identify opportunities to improve health care delivered and resources offered to these adolescents.
METHODS: Retrospective study of a consecutive sample of adolescent patients (12-18 years old) discharged from the hospitalist service at a large academic pediatric tertiary care center from May 2017 through April 2018. Data were collected regarding patient and hospital encounter characteristics including length of stay, admission service, reason for ingestion, substance(s) ingested, previous suicidal ideation (SI) screening, sexual history documentation, pregnancy testing, disposition at discharge and follow-up with primary care physicians (PCPs).
RESULTS: Most hospitalizations for ingestions were reported as intentional suicide attempts (79%). Most commonly, adolescents ingested exclusively prescription medications (45%) or over-the-counter medications (32%). Of adolescents with a reported suicide attempt for whom PCP records were available, 56% did not have SI screening documented in the medical record. One-quarter of adolescents hospitalized for an ingestion did not have a sexual history documented, and 11% of female patients were not tested for pregnancy before discharge. A majority (66%) of the adolescents with PCP records available did not follow-up with their PCP within 2 months after their hospitalization.
CONCLUSIONS: On the basis of our study results, opportunities to improve adolescent health include increased screening for SI and mental health symptoms throughout medical environments, comprehensive risk assessment of all adolescents hospitalized for an ingestion and increased guidance for caregivers of adolescents regarding prescription and over-the-counter medication storage in the home.
Author List
Titus L, Stephany A, Porada K, McFadden VAuthors
Vanessa Mcfadden MD Associate Professor in the Pediatrics department at Medical College of WisconsinLauren Titus MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentChild
Eating
Female
Hospitalization
Humans
Pregnancy
Retrospective Studies
Suicidal Ideation
Suicide, Attempted
