[Children's medically complex diseases unit. A model required in all our hospitals].

Autor:	Climent Alcalá FJ; Unidad de Patología Compleja, Servicio de Pediatría, Hospital La Paz, Madrid, España. Electronic address: Franciscojose.climent@salud.madrid.org., García Fernández de Villalta M; Unidad de Patología Compleja, Servicio de Pediatría, Hospital La Paz, Madrid, España., Escosa García L; Unidad de Patología Compleja, Servicio de Pediatría, Hospital La Paz, Madrid, España., Rodríguez Alonso A; Unidad de Patología Compleja, Servicio de Pediatría, Hospital La Paz, Madrid, España., Albajara Velasco LA; Unidad de Patología Compleja, Servicio de Pediatría, Hospital La Paz, Madrid, España.
Jazyk:	Spanish; Castilian
Zdroj:	Anales de pediatria [An Pediatr (Engl Ed)] 2018 Jan; Vol. 88 (1), pp. 12-18. Date of Electronic Publication: 2017 May 09.
DOI:	10.1016/j.anpedi.2017.04.002
Abstrakt:	Introduction: The increase in survival of children with severe diseases has led to the rise of children with chronic diseases, sometimes with lifelong disabilities. In 2008, a unit for the specific care of medically complex children (MCC) was created in Hospital La Paz. Objectives: To describe the work and care activities of this Unit. Patients and methods An analysis was performed on all discharge reports of the Unit between January 2014 and July 2016. Results: The MCC Unit has 6 beds and daily outpatient clinic. A total of 1,027 patients have been treated since the creation of the unit, with 243 from 2014. The median age was 24.2 months (IQ: 10.21-84.25). The large majority (92.59%) have multiple diseases, the most frequent chronic conditions observed were neurological (76.95%), gastrointestinal (63.78%), and respiratory diseases (61.72%). More than two-thirds (69.54%) of MCC are dependent on technology, 53.49% on respiratory support, and 35.80% on nutritional support. Hospital admission rates have increased annually. There have been 403 admissions since 2014, of which 8.93% were re-admissions within 30 days of hospital discharge. The median stay during 2014-2016 was 6 days (IQ: 3-14). The occupancy rate has been above 100% for this period. Currently, 210 patients remain on follow-up (86.42%), and 11 children (4.53%) were discharged to their referral hospitals. The mortality rate is 9.05% (22 deaths). The main condition of these 22 patients was neurological (9 patients). Infectious diseases were the leading cause of death. Conclusion: MCC should be treated in specialized units in tertiary or high-level hospitals. (Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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