Pediatric Chronic Pain Admissions Rise Dramatically

The researchers defined 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.

The results showed that mean age of these patients was 13.5 years, with only 235 patients aged 0–7 years. The majority (79%) was white, and girls outnumbered boys by 2.41:1. The most common admission and principal discharge diagnosis were abdominal pain (39%), mood disorders (28%), constipation (20%), nausea/vomiting/diarrhea (18%), anxiety and panic disorders (18%), and headaches (18%). Comorbid diagnoses were common, with 65% having a gastrointestinal (GI) diagnosis and 44% with a psychiatric diagnosis. The mean length of stay was 7.32 days, and 12.5% were readmitted at least once within the year. The study was published online on July 1, 2013, in Pediatrics.

“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,” concluded lead author Thomas Coffelt, MD, of the department of pediatrics, and colleagues. “Chronic pain pediatric admissions increased from 143 in 2004 to 1,188 in 2010, for an increase of 831%. Clearly, more information is needed on the underlying pathologic and social mechanisms that contribute to these patients' symptoms so that we can develop treatments targeted to those mechanisms.”

Chronic Pain Syndrome (CPS) is a common problem that is a major challenge to healthcare providers because of its complex nature of poor etiology and poor response to therapy, as well as problems arising from use of reactive symptomatic therapies such as opiates and benzodiazepines, such as an addictive potential and a tendency for adverse effects.

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