Establishing hospital admission criteria of pediatric Henoch-Schonlein purpura

Rheumatol Int. 2014 Nov;34(11):1497-503. doi: 10.1007/s00296-014-2971-9. Epub 2014 Feb 23.

Abstract

The current study aimed to define evidence-based admission criteria of pediatric Henoch-Schonlein purpura (HSP). In addition, we aimed to better characterize epidemiological and clinical features of pediatric HSP in Israel. We performed a retrospective cohort study of all children with HSP admitted during a 15 years period to a single pediatric department. We strictly collected the clinical data of all HSP cases. Each case was categorized as either "necessary admission" or "unnecessary admission." We compared the two groups, using initially Chi square (χ(2)) and student "t" tests, and thereafter, we employed logistic stepwise regression analysis. One hundred and sixty-three children with HSP were included. A set of six clinical criteria of which the presence of minimum one predicts the need for hospitalization were identified including: orchitis, moderate or severe abdominal pain, arthritis involving more than two joints, proteinuria, clear evidence of gastrointestinal bleeding, and inability to ambulate. In conclusion, we suggest a predictive model for the admission of pediatric patients with acute HSP. The implementation of this model can significantly reduce unnecessary admissions.

MeSH terms

  • Adolescent
  • Age Factors
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Decision Support Techniques*
  • Female
  • Humans
  • IgA Vasculitis / diagnosis*
  • IgA Vasculitis / drug therapy
  • IgA Vasculitis / epidemiology
  • Infant
  • Israel / epidemiology
  • Logistic Models
  • Male
  • Patient Admission / standards*
  • Predictive Value of Tests
  • Retrospective Studies
  • Severity of Illness Index
  • Steroids / therapeutic use
  • Time Factors
  • Treatment Outcome
  • Unnecessary Procedures

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Steroids