Inpatient Characteristics of the Child Admitted With Chronic Pain

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Children with chronic pain complaints seem to represent an increasing portion of general pediatric inpatient services. Few data exist, however, on the characteristics of this population, their length of stay, or the best approach to their evaluation and management. WHAT THIS STUDY ADDS:This study defines the demographic, diagnostic, procedural, and episode of care characteristics for children admitted to the acute care setting with chronic pain syndromes. Admission rates are rising, lengths of stay are substantial, and comorbid diagnoses are common. abstract 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.

Systematic Review on Intensive Interdisciplinary Pain Treatment of Children With Chronic Pain

“…There is an increasing number of children who present to hospitals for treatment of chronic pain. 1 The most common chronic pain conditions include headache, functional abdominal pain, and musculoskeletal pain, including back pain. 2,3 Many of these children are severely impaired in their daily activities; they are unable to attend school regularly, and often suffer from severe emotional distress.…”

Integrative Care Therapies and Pain in Hospitalized Children and Adolescents: A Retrospective Database Review

“…Pain is a major clinical issue for hospitalized children and incurs major costs for hospitals as unresolved pain can be related to longer hospital stays, increased number of adverse events, higher incidence of pain medications and procedures, and ultimately can negatively affect the child's and families' quality of life. 29,30 Future studies should evaluate pain medications in combination with delivering adjuvant integrative care therapies to assess their combined effect on outcomes.…”

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

“…Girls are three times more likely to report chronic pain than boys [232,233]. Abdominal pain is significantly more likely to be reported by girls and limb pain (or growing pains/muscle aches) is significantly more likely to be reported by boys [230,233,234]. Although prevalence of chronic pain in school children varies from 9 to 32% [235,236] and is on an increase [234], the reported prevalence exceeds the prevalence of school aged children seeking medical care for pain [237].…”

“…Abdominal pain is significantly more likely to be reported by girls and limb pain (or growing pains/muscle aches) is significantly more likely to be reported by boys [230,233,234]. Although prevalence of chronic pain in school children varies from 9 to 32% [235,236] and is on an increase [234], the reported prevalence exceeds the prevalence of school aged children seeking medical care for pain [237]. Cross-sectional and/or retrospective studies may not reflect the true picture and call for more longitudinal research to establish the actual prevalence and impacts of ongoing pain in children and youths has been advocated [238].…”