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Inpatient characteristics of the child admitted with chronic pain
Thomas A Coffelt1, Benjamin D Bauer, Aaron E Carroll
1Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. tcoffelt@iupui.edu
Insights
Admissions for pediatric chronic pain surged by 831% between 2004-2010. The average patient was a teenaged female with multiple gastrointestinal and psychiatric conditions, indicating significant healthcare resource use.
Area of Science:
- Pediatric Health Services Research
- Pain Medicine
- Health Informatics
Background:
- Chronic pain in children is a growing concern.
- Understanding the characteristics of pediatric chronic pain admissions is crucial for resource allocation and care improvement.
Purpose of the Study:
- To define the demographic, diagnostic, procedural, and episode of care characteristics for children admitted with chronic pain.
- To analyze trends in pediatric chronic pain admissions.
Main Methods:
- Utilized the Pediatric Health Information System database (2004-2010).
- Excluded specific patient groups (sickle cell disease, cancer, burns, cerebral palsy, transplants, ventilator-dependent).
- Analyzed demographic data, length of stay, readmission rates, diagnoses, and procedures.
Main Results:
- A total of 3752 pediatric chronic pain admissions were identified, with an 831% increase from 2004-2010.
- The average patient was a 13.5-year-old female, predominantly white (79%).
- Abdominal pain was the most common diagnosis; patients averaged 10 diagnoses, with high rates of gastrointestinal (65%) and psychiatric (44%) comorbidities. Mean length of stay was 7.32 days, and 12.5% were readmitted within a year.
Conclusions:
- Pediatric chronic pain admissions are increasing significantly, characterized by adolescent females with complex comorbidities.
- These admissions represent substantial healthcare resource utilization.
- Further research is needed to optimize care and improve outcomes for this population.
Objective:
To define the demographic, diagnostic, procedural, and episode of care characteristics for children admitted with chronic pain.
Methods:
We used the Pediatric Health Information System database to obtain data on demographic characteristics, length of stay, readmission rates, diagnoses, and procedures for children admitted with chronic pain. Patients with sickle cell disease, cancer, burns, cerebral palsy, transplants, and ventilator-dependent children were excluded.
Results:
A total of 3752 patients with chronic pain were identified from 2004 through 2010. Admissions increased by 831% over this time period. The mean age of these patients was 13.5 years, the most common race was white (79%), and female subjects outnumbered male subjects by 2.41 to 1. The most common admission and principal discharge diagnosis was abdominal pain; comorbid diagnoses were common, with a mean of 10 diagnoses per patient. In total, 65% of patients had a comorbid gastrointestinal diagnosis and 44% had a psychiatric diagnosis. The mean length of stay was 7.32 days, with an expected length of stay of 4.24 days; 12.5% were readmitted at least once within 1 year. They underwent a mean of 3.18 procedures per patient.
Conclusions:
The average child admitted with chronic pain is a teenaged female with a wide variety of comorbid conditions, many of which are gastrointestinal and psychiatric in nature. Admissions for chronic pain are rising and account for substantial resource utilization. Future studies should further characterize this population, with the overall objective of improving outcomes and optimizing cost-effective care.
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