title: Children with chronic conditions in a paediatric emergency department.
abstract: OBJECTIVE
  To describe the use of a paediatric emergency department by children with chronic conditions.
  
  
  METHODS
  We prospectively indexed all the children seen in our emergency department during 1 y to describe the population of children with chronic conditions, and to compare it with the general paediatric population.
  
  
  RESULTS
  There were 11,483 patient visits, of which 11% were by chronically ill children. Six subspeciality areas accounted for the vast majority of the chronic conditions seen: neurology (30%), cardiology (18%), pulmonology (18%), nephro-urology (16%), haemato-oncology (9%) and endocrinology (4%). Admission rate to the hospital was significantly higher for chronically ill patients (38% vs 23%). Among chief complaints, fever, respiratory distress, headache and seizures were overrepresented in chronically ill children. The chief complaint was related to the child's chronic condition in 51% of the visits. In both chronically and non-chronically ill patients, the majority of final diagnoses were related to infection (57% and 65%, respectively). Among diagnoses, bacterial infections, seizures, vasovagal syncopes and asthma were overrepresented in chronically ill children.
  
  
  CONCLUSIONS
  From the analysis of our data, we conclude that children with chronic conditions account for a tenth of all visits to a paediatric emergency department. The paediatric emergency physicians provide an important service to both the children with chronic conditions and the subspecialists who care for them.
authors.affiliation: Department of Paediatrics, C.H.R. Citadelle, University of Liège, B-4000 Liège, Belgium. martial.massin@chrcitadelle.be
authors.forename: Martial M
authors.initials: MM
authors.lastname: Massin
authors.forename: Jessica
authors.initials: J
authors.lastname: Montesanti
authors.forename: Paul
authors.initials: P
authors.lastname: Gérard
authors.forename: Philippe
authors.initials: P
authors.lastname: Lepage
mesh_terms: D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002908:Chronic Disease; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D017678:Sex Distribution