ISSN - 0973-0958

Pediatric Oncall Journal View 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.
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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