Analysis of the spectrum of critical illnesses in the emergency department of Hebei Children's Hospital: A single-center study

Objective To analyze the distribution and epidemiological characteristics of critical illnesses in the emergency department of Hebei Children's Hospital. Method Through retrospective medical record review, patients triaged as level Ⅰ or Ⅱ (aged 0–18 years) who visited the emergency department of the hospital from January 2023 to December 2024 were included. The distribution of diseases, age, gender, season and other indicators were statistically analyzed. Results A total of 1,450 critically ill patients with triage levels Ⅰ and Ⅱ were included. The median (IQR) age of all patients was 4.00 (1.00, 9.00) years, and the male-to-female ratio was 1.2:1. Among each age group, the 1 to <3 years group had a proportion of 27.9%, and the 0 to <1 year group had a proportion of 9.5%, representing the highest and lowest values, respectively. The distribution of critical illnesses in the emergency department of this hospital was led by the nervous system (n = 548, 37.8%), trauma and accidental injuries (n = 286, 19.7%), and the respiratory system (n = 214, 14.8%), which ranked as the top three categories. The top five primary diagnosed diseases were seizure (n = 352, 24.3%), drug poisoning (n = 242, 16.7%), severe pneumonia (n = 137, 9.5%), status epileptics (n = 137, 9.5%), and arrhythmia (n = 102, 7.0%). Among them, the proportion of severe pneumonia was the highest in the 0 to <1 year group; the proportion of seizure was the highest in the 1 to <3 years group, 3 to <6 years group and 6 to <12 years group, while the proportion of drug poisoning was the highest in the 12 to <18 years group. The distribution of the top five disease differed significantly across age groups ( p < 0.001) and seasons ( p = 0.004). Cardiopulmonary arrest (CPA) is one of the most critical conditions in an emergency department. However, the distribution of diseases causing CPA did not show significant differences by age or season. The top three diseases causing CPA are severe pneumonia, asphyxia, and multiple body region injuries (Road traffic accident) . Conclusion The spectrum of critical illnesses varied significantly by age and seasonal distribution in the emergency department of Hebei Children's Hospital. Therefore, age and season-tailored approaches are recommended for managing common critical illnesses, whereas CPA requires a standardized, universally applied emergency response. It is necessary to further strengthen training and optimize resource allocation.