Pediatric emergency department use by adults with chronic pediatric disorders

William M. McDonnell, Irene Kocolas, Genie E. Roosevelt, Angela T. Yetman

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Objective: To describe pediatric emergency department use by adults with chronic pediatric disorders, known as transition patients. Design: Retrospective descriptive study. Setting: The pediatric emergency department of a tertiary care pediatric hospital during calendar year 2005. Participants: All patients presenting to the pediatric emergency department during the study period. Main Outcome Measures: Association of presenting complaint with the patient's chronic pediatric disorder, emergency department interventions and dispositions, and duration of inpatient admissions. Results: Patient encounters totaled 43 621, with 445 (1%) involving adult patients. Transition patients accounted for 197 (44%) of the adult encounters. Eighty-nine transition patient encounters (45%) were for complaints unrelated to the patients' chronic pediatric disorders. Only 14 (7%) transition patient visits did not involve diagnostic studies or procedures. Transition patients were 2.1 times (95% confidence interval, 1.8-2.5; P<.001) more likely to require admission than pediatric patients and were 4.5 times (95% confidence interval, 3.3-6.1; P<.001) more likely to require intensive care. Median length of stay for admitted transition patients was 4 days (range, 1-35 days) compared with 2 days (range, 1-80 days) for pediatric patients (P<.001). Conclusions: A substantial number of adult patients with chronic pediatric disorders use the pediatric emergency department and often present with complaints unrelated to their pediatric conditions. They have high rates of hospital and intensive care unit admissions. Pediatric hospitals should be prepared with adequate resources and training to deal with these complex adult patients.

Original languageEnglish (US)
Pages (from-to)572-576
Number of pages5
JournalArchives of Pediatrics and Adolescent Medicine
Issue number6
StatePublished - Jun 2010
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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