HEADS-ED as a Predictor of Hospitalization in Children Seeking Emergency Department Care With Mental Health Concerns

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-04-21 DOI:10.1016/j.acap.2025.102845

Hannah Byles MD , Amanda S. Newton PhD , Jianling Xie MD, MPH , Kathleen Winston MSc , Mario Cappelli PhD , Jennifer Thull-Freedman MD, MSc , Stephen B. Freedman MDCM, MSc , on behalf of Pediatric Emergency Research Canada (PERC)

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引用次数: 0

Abstract

Objective

To evaluate the association between the Home, Education/Employment, Activities, Drugs, Suicidality, Emotions, Discharge (HEADS-ED) tool and hospitalization among children presenting with mental health concerns for emergency department (ED) care.

Methods

We conducted a cross-sectional analysis of data from a prospective quasi-experimental study evaluating an acute mental health care bundle in 2 pediatric EDs in Alberta, Canada. Participants were <18 years and presented with a mental health concern. A high-risk HEADS-ED score was defined by a total score ≥8 (range: 0–14) and/or suicide score of 2 (range: 0–2). Primary outcome was index ED visit hospitalization.

Results

Seven hundred and fourteen eligible participants had complete data available for analysis. Median participant age was 14.0 (interquartile range [IQR]: 12.0, 15.0) years, 12.0% (86/714) of whom were hospitalized at the index ED visit. The HEADS-ED score was ≥8 for 16.9% (121/714) of participants and 28.6% (204/714) had a suicide risk score of 2; 35.7% (255/714) met one or both high-risk criteria. Exactly 79.1% (95%confidence interval [CI]: 69.0, 87.1) of hospitalizations were among children who had high-risk scores, whereas 70.2% (95%CI: 66.5, 73.8) of children who were discharged had low-risk scores. Similarly, including follow-up through 30 days after the index visit, 77.7% (95%CI: 67.9, 85.6) of hospitalizations were among children who had high-risk scores, while 70.7% (95%CI: 66.9, 74.2) of children who were not hospitalized had low-risk scores. Among children ≥14 years, HEADS-ED scores were inversely correlated with well-being scores.

Conclusion

In our study population, high-risk HEADS-ED scores are moderately associated with hospitalization. Adolescents with higher HEADS-ED scores reported lower well-being.

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HEADS-ED作为有心理健康问题的儿童寻求急诊科护理住院的预测因子

目的：评价HEADS-ED工具与急诊科（ED）治疗中出现精神健康问题的儿童住院之间的关系。研究设计：我们对来自一项前瞻性准实验研究的数据进行了横断面分析，该研究评估了加拿大阿尔伯塔省两家儿科急诊科的急性精神卫生保健套餐。结果：714名符合条件的参与者有完整的数据可用于分析。参与者的中位年龄为14.0岁（IQR: 12.0, 15.0），其中12.0%（86/714）的参与者在索引ED就诊时住院。16.9%（121/714）的参与者的HEADS-ED得分≥8分，28.6%（204/714）的参与者的自杀风险得分为2分；35.7%（255/714）符合一项或两项高危标准。79.1% （95%CI: 69.0, 87.1）的住院儿童评分为高危，而70.2% （95%CI: 66.5, 73.8）的出院儿童评分为低危。同样，包括指数访问后30天的随访，77.7% （95% CI: 67.9, 85.6）的住院儿童是高危评分的儿童，而70.7% （95% CI: 66.9, 74.2）未住院的儿童是低风险评分的儿童。在≥14岁的儿童中，HEADS-ED得分与幸福感得分呈负相关。结论：在我们的研究人群中，高危HEADS-ED评分与住院治疗有中度相关性。head - ed得分较高的青少年幸福感较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.