Association of Respiratory Pathogen Panel Testing on the Proportion of Emergency Department Revisits in Children With Symptoms of Upper Respiratory Illness

OBJECTIVE: Acute respiratory tract infections are the main cause of morbidity and emergency department visits for children. Recent advances in testing have brought about the ability to quickly diagnose many of the pathogens contributing to viral respiratory illness. The purpose of the study is to evaluate respiratory pathogen panel testing versus clinical diagnosis on the proportion of emergency department (ED) same-site revisits in an uncomplicated, healthy pediatric population. METHODS: This was an IRB-approved, retrospective cohort study. Patients discharged from the ED between the ages of 6 months to 3 years with a discharge diagnosis of acute upper respiratory infection from January 1, 2015, to May 31, 2023, were screened for inclusion. The primary outcome was the proportion of ED revisits within 3 days for upper respiratory illness-related complaints. RESULTS: There was no difference in ED revisits with 6% of patients in the RPP group versus 5% of patients in the No-RPP group returning in 3 days for upper respiratory complaints ( P =0.57). Of the 16 patients with RPP returning to the ED, the most common organism identified was rhinovirus/enterovirus. There was no difference in ED disposition after revisit, with the majority of patients discharging to home. CONCLUSIONS: The results of this study demonstrated no difference in the proportion of return visits to the ED in overall healthy children presenting with uncomplicated acute respiratory illness. These results support the consensus that viral respiratory panel testing may be performed on a selective basis to drive care in the emergency department.