Niños y adolescentes con necesidades especiales de atención en salud: prevalencia hospitalaria y riesgos asociados

• Juan Carlos Flores ^[3] ; Daniela Carrillo ^[1] ; Lorena Karzulovic ^[1] ; Jaime Cerda ^[1] ; Gabriela Araya ^[1] ; María Soledad Matus ^[1] ; Guillermo LLévenes ^[1] ; Gonzalo Menchaca ^[3] ; Nelson A Vargas ^[2]
  1. [1] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  2. [2] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  3. [3] Complejo Asistencial Dr. Sótero del Río Servicio de Salud Metropolitano Sur Oriente

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 140, Nº. 4, 2012, págs. 458-465
• Idioma: español
• Títulos paralelos:
  • Children with special health care needs: prevalence in a pediatric hospital and associated
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  • Background: "Children with special health care needs" (CSHCN) is a novel definition for pediatric patients with chronic diseases, adopted by the Chilean Pediatric Society in 2008. As life expectancy in Chile increases, prevalence of CSHCN is progressively growing, leading to higher health costs. Aim: To describe the epide-miological profile and clinical characteristics of hospitalized CSHCN, and compare the risk assessment of adverse events during hospitalization using two definitions for CSHCN. Patients and Methods: A cohort of hospitalized CSHCN in a Pediatric Center at Santiago, Chile, was followed from September to December 2009. Clinical and demographic data were registered in a database, including admission to intensive care unit (ICU), nosocomial infections and prolonged hospitalization (> 7 days). Incidence ratios for these events were compared between CSHCN and non-CSHCN, and between children attended by three or more health care professionals (CSHCN-3) and non-CSHCN. Results: Nine hundred twenty patients were included (54% male), with a median age 14 months (0-221) and median days of hospitalization 4 days (1-229). Prevalence of CSHCN was 60.8% of hospitalized children. When using CSHCN definition and comparing with non-CSHCN, no excess of risk was documented. On the other hand, prevalence of CSHCN-3 was 19.9%. Compared to non-CSHCN, these patients had a higher risk of ICU admission (relative risk (RR) 1.58; 95% confidence intervals (CI) = 1.22-2.05; p < 0.01), nosocomial infections (RR 2.28; 95% CI = 1.54-3.39; p < 0.001) and prolonged hospitalization (RR 1.99; 95% CI = 1.52-2.60; p < 0.001). Conclusions: One in five hospitalized children met CSHCN-3 definition. These patients had an increased risk of adverse events during their hospitalization compared to non-CSHCN.