COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES

Detalhes bibliográficos
Autor(a) principal: Passone,Caroline Gouveia Buff
Data de Publicação: 2020
Outros Autores: Grisi,Sandra Josefina, Farhat,Sylvia Costa, Manna,Thais Della, Pastorino,Antonio Carlos, Alveno,Renata Antunes, Miranda,Caroline Vasconcelos Sá, Waetge,Aurora Rosaria, Cordon,Mariana Nutti, Odone-Filho,Vicente, Tannuri,Uenis, Carvalho,Werther Brunow, Carneiro-Sampaio,Magda, Silva,Clovis Artur
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Paulista de Pediatria (Ed. Português. Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822020000100402
Resumo: ABSTRACT Objective: To assess demographic data and characteristics of children and adolescents with pediatric chronic diseases (PCD), according to the number of specialties/patient. Methods: We performed a cross-sectional study with 16,237 PCD patients at outpatient clinics in one year. Data were analyzed by an electronic data system, according to the number of physician appointments for PCD. This study assessed: demographic data, follow-up characteristics, types of medical specialty, diagnosis (International Statistical Classification of Diseases and Related Health Problems - ICD-10), number of day hospital clinic visits, and acute complications. Results: Patients followed by ≥3 specialties simultaneously showed a significantly higher duration of follow-up compared to those followed by ≤2 specialties [2.1 (0.4-16.4) vs. 1.4 (0.1-16.2) years; p<0.001] and a higher number of appointments in all specialties. The most prevalent medical areas in patients followed by ≥3 specialties were: Psychiatry (Odds Ratio - OR=8.0; confidence interval of 95% - 95%CI 6-10.7; p<0.001), Palliative/Pain Care (OR=7.4; 95%CI 5.7-9.7; p<0.001), Infectious Disease (OR=7.0; 95%CI 6.4-7.8; p<0.001) and Nutrology (OR=6.9; 95%CI 5.6-8.4; p<0.001). Logistic regressions demonstrated that PCD patients followed by ≥3 specialties were associated with high risk for: number of appointments/patient (OR=9.2; 95%CI 8.0-10.5; p<0.001), day hospital clinic visits (OR=4.8; 95%CI 3.8-5.9; p<0.001), emergency department visits (OR=3.2; 95%CI 2.9-3.5; p<0.001), hospitalizations (OR=3.0; 95%CI 2.7-3.3; p<0.001), intensive care admissions (OR=2.5; 95%CI 2.1-3.0; p<0.001), and deaths (OR=2.8; 95%CI 1.9-4.0; p<0.001). The diagnosis of asthma, obesity, chronic pain, and transplant was significantly higher in patients followed by ≥3 specialties. Conclusions: The present study showed that PCD patients who required simultaneous care from multiple medical specialties had complex and severe diseases, with specific diagnoses.
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spelling COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIESChronic diseaseChildAdolescentEmergencyIntensive care unitHospitalizationABSTRACT Objective: To assess demographic data and characteristics of children and adolescents with pediatric chronic diseases (PCD), according to the number of specialties/patient. Methods: We performed a cross-sectional study with 16,237 PCD patients at outpatient clinics in one year. Data were analyzed by an electronic data system, according to the number of physician appointments for PCD. This study assessed: demographic data, follow-up characteristics, types of medical specialty, diagnosis (International Statistical Classification of Diseases and Related Health Problems - ICD-10), number of day hospital clinic visits, and acute complications. Results: Patients followed by ≥3 specialties simultaneously showed a significantly higher duration of follow-up compared to those followed by ≤2 specialties [2.1 (0.4-16.4) vs. 1.4 (0.1-16.2) years; p<0.001] and a higher number of appointments in all specialties. The most prevalent medical areas in patients followed by ≥3 specialties were: Psychiatry (Odds Ratio - OR=8.0; confidence interval of 95% - 95%CI 6-10.7; p<0.001), Palliative/Pain Care (OR=7.4; 95%CI 5.7-9.7; p<0.001), Infectious Disease (OR=7.0; 95%CI 6.4-7.8; p<0.001) and Nutrology (OR=6.9; 95%CI 5.6-8.4; p<0.001). Logistic regressions demonstrated that PCD patients followed by ≥3 specialties were associated with high risk for: number of appointments/patient (OR=9.2; 95%CI 8.0-10.5; p<0.001), day hospital clinic visits (OR=4.8; 95%CI 3.8-5.9; p<0.001), emergency department visits (OR=3.2; 95%CI 2.9-3.5; p<0.001), hospitalizations (OR=3.0; 95%CI 2.7-3.3; p<0.001), intensive care admissions (OR=2.5; 95%CI 2.1-3.0; p<0.001), and deaths (OR=2.8; 95%CI 1.9-4.0; p<0.001). The diagnosis of asthma, obesity, chronic pain, and transplant was significantly higher in patients followed by ≥3 specialties. Conclusions: The present study showed that PCD patients who required simultaneous care from multiple medical specialties had complex and severe diseases, with specific diagnoses.Sociedade de Pediatria de São Paulo2020-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822020000100402Revista Paulista de Pediatria v.38 2020reponame:Revista Paulista de Pediatria (Ed. Português. Online)instname:Sociedade de Pediatria de São Paulo (SPSP)instacron:SPSP10.1590/1984-0462/2020/38/2018101info:eu-repo/semantics/openAccessPassone,Caroline Gouveia BuffGrisi,Sandra JosefinaFarhat,Sylvia CostaManna,Thais DellaPastorino,Antonio CarlosAlveno,Renata AntunesMiranda,Caroline Vasconcelos SáWaetge,Aurora RosariaCordon,Mariana NuttiOdone-Filho,VicenteTannuri,UenisCarvalho,Werther BrunowCarneiro-Sampaio,MagdaSilva,Clovis Artureng2020-11-03T00:00:00Zoai:scielo:S0103-05822020000100402Revistahttps://www.rpped.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.phppediatria@spsp.org.br||rpp@spsp.org.br1984-04620103-0582opendoar:2020-11-03T00:00Revista Paulista de Pediatria (Ed. Português. Online) - Sociedade de Pediatria de São Paulo (SPSP)false
dc.title.none.fl_str_mv COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
title COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
spellingShingle COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
Passone,Caroline Gouveia Buff
Chronic disease
Child
Adolescent
Emergency
Intensive care unit
Hospitalization
title_short COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
title_full COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
title_fullStr COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
title_full_unstemmed COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
title_sort COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES
author Passone,Caroline Gouveia Buff
author_facet Passone,Caroline Gouveia Buff
Grisi,Sandra Josefina
Farhat,Sylvia Costa
Manna,Thais Della
Pastorino,Antonio Carlos
Alveno,Renata Antunes
Miranda,Caroline Vasconcelos Sá
Waetge,Aurora Rosaria
Cordon,Mariana Nutti
Odone-Filho,Vicente
Tannuri,Uenis
Carvalho,Werther Brunow
Carneiro-Sampaio,Magda
Silva,Clovis Artur
author_role author
author2 Grisi,Sandra Josefina
Farhat,Sylvia Costa
Manna,Thais Della
Pastorino,Antonio Carlos
Alveno,Renata Antunes
Miranda,Caroline Vasconcelos Sá
Waetge,Aurora Rosaria
Cordon,Mariana Nutti
Odone-Filho,Vicente
Tannuri,Uenis
Carvalho,Werther Brunow
Carneiro-Sampaio,Magda
Silva,Clovis Artur
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Passone,Caroline Gouveia Buff
Grisi,Sandra Josefina
Farhat,Sylvia Costa
Manna,Thais Della
Pastorino,Antonio Carlos
Alveno,Renata Antunes
Miranda,Caroline Vasconcelos Sá
Waetge,Aurora Rosaria
Cordon,Mariana Nutti
Odone-Filho,Vicente
Tannuri,Uenis
Carvalho,Werther Brunow
Carneiro-Sampaio,Magda
Silva,Clovis Artur
dc.subject.por.fl_str_mv Chronic disease
Child
Adolescent
Emergency
Intensive care unit
Hospitalization
topic Chronic disease
Child
Adolescent
Emergency
Intensive care unit
Hospitalization
description ABSTRACT Objective: To assess demographic data and characteristics of children and adolescents with pediatric chronic diseases (PCD), according to the number of specialties/patient. Methods: We performed a cross-sectional study with 16,237 PCD patients at outpatient clinics in one year. Data were analyzed by an electronic data system, according to the number of physician appointments for PCD. This study assessed: demographic data, follow-up characteristics, types of medical specialty, diagnosis (International Statistical Classification of Diseases and Related Health Problems - ICD-10), number of day hospital clinic visits, and acute complications. Results: Patients followed by ≥3 specialties simultaneously showed a significantly higher duration of follow-up compared to those followed by ≤2 specialties [2.1 (0.4-16.4) vs. 1.4 (0.1-16.2) years; p<0.001] and a higher number of appointments in all specialties. The most prevalent medical areas in patients followed by ≥3 specialties were: Psychiatry (Odds Ratio - OR=8.0; confidence interval of 95% - 95%CI 6-10.7; p<0.001), Palliative/Pain Care (OR=7.4; 95%CI 5.7-9.7; p<0.001), Infectious Disease (OR=7.0; 95%CI 6.4-7.8; p<0.001) and Nutrology (OR=6.9; 95%CI 5.6-8.4; p<0.001). Logistic regressions demonstrated that PCD patients followed by ≥3 specialties were associated with high risk for: number of appointments/patient (OR=9.2; 95%CI 8.0-10.5; p<0.001), day hospital clinic visits (OR=4.8; 95%CI 3.8-5.9; p<0.001), emergency department visits (OR=3.2; 95%CI 2.9-3.5; p<0.001), hospitalizations (OR=3.0; 95%CI 2.7-3.3; p<0.001), intensive care admissions (OR=2.5; 95%CI 2.1-3.0; p<0.001), and deaths (OR=2.8; 95%CI 1.9-4.0; p<0.001). The diagnosis of asthma, obesity, chronic pain, and transplant was significantly higher in patients followed by ≥3 specialties. Conclusions: The present study showed that PCD patients who required simultaneous care from multiple medical specialties had complex and severe diseases, with specific diagnoses.
publishDate 2020
dc.date.none.fl_str_mv 2020-01-01
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dc.relation.none.fl_str_mv 10.1590/1984-0462/2020/38/2018101
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dc.publisher.none.fl_str_mv Sociedade de Pediatria de São Paulo
publisher.none.fl_str_mv Sociedade de Pediatria de São Paulo
dc.source.none.fl_str_mv Revista Paulista de Pediatria v.38 2020
reponame:Revista Paulista de Pediatria (Ed. Português. Online)
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reponame_str Revista Paulista de Pediatria (Ed. Português. Online)
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