Clinical Features of Adult Patients Admitted to Pediatric Wards in Japan
Nobuaki Michihata1, Hiroki Matsui1, Kiyohide Fushimi2
1Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Insights
Adult patients in pediatric wards often have chronic childhood conditions or adult diseases. A disease-oriented support system is crucial for these long-term pediatric care patients.
Area of Science:
- Pediatric care
- Internal medicine
- Healthcare management
Background:
- Pediatricians increasingly manage adult patients with chronic pediatric diseases.
- Limited data exists on the characteristics of adult inpatients in pediatric settings.
Purpose of the Study:
- To characterize adult patients admitted to Japanese pediatric wards.
- To identify clinical details and diagnoses of this patient population.
Main Methods:
- Analysis of a national inpatient database in Japan (April 2012-March 2013).
- Inclusion of inpatients aged 19 years and older admitted to pediatric departments.
- Examination of primary diagnoses and use of home medical devices.
Main Results:
- 1.1% (4,729/417,352) of pediatric ward patients were adults (≥19 years).
- Common diagnoses included malignancy, congenital heart disease, epilepsy, and cerebral palsy.
- Over 35% of cerebral palsy patients used respiratory or nutritional support devices; >20% of adults ≥40 years had adult diseases.
Conclusions:
- Adult patients in pediatric wards frequently present with adult-onset diseases.
- Developing specialized support systems for adults with childhood-onset chronic conditions is essential.
Purpose:
Pediatricians generally need to treat adult patients who require long-term care for pediatric diseases. However, little is known about the characteristics of adult patients in pediatric wards. Using a national inpatient database, the aim of this study was to determine the clinical details of adult patients admitted to pediatric wards in Japanese acute-care hospitals.
Methods:
We extracted all inpatients aged ≥19 years who were admitted to pediatric departments in Japan from April 2012 to March 2013. We examined the patients' main diagnoses and the use of life-supporting home medical devices.
Results:
Of 417,352 patients admitted to pediatric wards during the study period, we identified 4,729 (1.1%) adult patients. The major diagnoses of the adult patients were malignancy, congenital heart disease, epilepsy, and cerebral palsy. More than 35% of the patients with cerebral palsy had a tracheostomy tube, gastrostomy tube, home central venous alimentation, or home respirator. More than 20% of patients aged ≥40 years in pediatric wards had adult diseases, including ischemic heart diseases, cerebrovascular diseases, and adult malignancy.
Conclusions:
Many adult patients in pediatric wards had adult diseases. It is essential to establish a disease-oriented support system for adults with chronic conditions that originated in their childhood.
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