Pediatric department hospital admissions due to complex chronic conditions: a retrospective study

ORIGINAL ARTICLE

Pediatric Department Hospital admissions due to Complex Chronic Conditions: A Retrospective Study

Andreia Romana¹, Maria Filomena Cardosa¹, Cristina Lorenzo², Joana Matias¹, Marta Almeida¹, Paulo Calhau¹.

¹Department of Pediatrics, Hospital Garcia de Orta, Almada, Portugal,
²Department of Pediatrics, Hospital de Santa Maria - Centro Hospitalar Universitário de Lisboa Norte, EPE, Lisboa, Portugal.

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Abstract
Introduction: Complex chronic conditions are becoming more prevalent in paediatric age, as a group of diseases requiring a multiplicity of care and technological resources and with a great impact on children, family, and society. Palliative care has a growing significance in its approach.
Methods: Observational, longitudinal, and retrospective analysis of hospital admissions due to complex chronic conditions in the Paediatric Ward of a level II hospital over a five-year-period (2015-2019).
Results: We had 431 hospitalizations (209 patients), corresponding to 18% of total hospital admissions in the period studied. Median length of stay was 5 days. Male sex counted for 59% of all hospitalizations and median age was 5 years. The most frequent categories were neurologic and neuromuscular disorders (39%) and hematologic disorders (23%); the main diagnosis were sickle cell disease (23%) and cerebral palsy (16%). We verified pluripathology in 15% and polymedication in 32%. The most associated comorbidities were epilepsy (29%) and sleep disorders (18%). Dependency on technological support was found in 26%. The decompensation of the underlying disease was the main reason for hospitalization (52%); 4 hospitalizations were aimed to caregiver’s rest. 14% of patients had ambulatory’s specific support. Death occurred in 4 patients.
Conclusion: This study, innovative at national level, revealed a significant rate of hospital admissions due to complex chronic conditions. Awareness of this reality is essential for planning a suitable healthcare system based on a multidisciplinary approach. It is crucial to encourage our national Paediatric Palliative Care network and enhance education and social security support.

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