ABSTRACT
Introduction:
The aim of this study was to retrospectively evaluate the age and gender profiles of patients in the 0-18 age group, who presented to the pediatric emergency department with the complaint of pain.
Methods:
A total of 7712 patients aged 0-18, who presented to the pediatric emergency department of a state hospital between 01.01.2017 and 31.12.2017 with the complaint of pain, were included in this study. The data acquired from the Patient Information Management System (PIMS) program were analyzed using the Microsoft Excel program.
Results:
Of the 7712 patients, 62.1% were girl and 26.6% were in the age group of 15-18 years. The presenting complaints were stomach ache (77.5%), headache (6.4%), chest pain (6%), myalgia (4.7%), dysmenorrhea (2.9%), arthralgia (1.8%) and low back pain (0.7%). Stomach ache was more frequent among girls in the age group of 0-4 years (24%), headache among girls in the age group of 15-18 years (28%), chest pain among boys in the age group of 10-14 years (27.7%), myalgia among boys in the age group of 15-18 years (29%), dysmenorrhea among girls in the age group of 15-18 years (91.6%), arthralgia among girls in the age group of 15-18 years (22.9%), and low back pain among boys in the age group of 15-18 years (39.6%).
Conclusion:
It was concluded that girls and children in the age group of 15-18 years applied more frequently to the emergency department due to pain and, in terms of their diagnoses, they were the patients who could also receive treatment in primary healthcare services and general outpatient clinics.
Keywords:
Emergency service, pain, child, nursing
References
1Köse A, Köse B, Öncü MR, Tuğrul F. Bir devlet hastanesi acil servisine başvuran hastaların profili ve başvurunun uygunluğu. Gaziantep Tıp Derg. 2011;17:57-62.
2Wier LM, Yu H, Owens PL, Washington R. Overview of Children in the Emergency Department, 2010, Healthcare Cost And Utilization Project, Statistical Brief #157.2013. Available at: https://europepmc.org/books/NBK154386/pdf/Bookshelf_NBK154386.pdf. Accessed April 10, 2018.
3National Hospital Ambulatory Medical Care Survey: 2015 Emergency Department Summary Tables Available at:https://www.cdc.gov/nchs/data/nhamcs/web_tables/2015_ed_web_tables.pdf Accessed January 17, 2018.
4Türkiye Kamu Hastaneleri Genel Müdürlüğü İstatistik, Analiz, Raporlama ve Stratejik Yönetim Dairesi Başkanlığı 2017 Yılı Ocak-Ekim Dönemi Acil Servislere İlişkin Veriler Aralık 2017. https://www.saglikaktuel.com/d/file/a44e5cb22e534ab9977ddfe79faa358f.pdf Erişim:10.05.2018.
5Grove DD, Lazebnik R, Petrack EM. Urban emergency department utilization by adolescents. Clin Pediatr. 2000;39:479-83.
6Wilson KM, Klein JD. Adolescents who use the emergency department as their usual source of care. Arch Pediatr Adolesc Med. 2000;154:361-5.
7Eti Aslan F, Badır A. Ağrı kontrol gerçeği: hemşirelerin ağrının doğası, değerlendirilmesi ve geçirilmesine ilişkin bilgi ve inançları. Ağrı. 2005;17:44-51.
8International Association for Study of Pain (IASP). Available at: http://www.iasp-pain.org/terminology?navItemNumber=576#Pain. Accessed May 09, 2018.
9Richards J, Hubbert AO. Experiences of expert nurses in caring for patients with postoperative pain. Pain Manag Nurs. 2007;8:17-24.
10Erdine S. Ağrı mekanizmaları giriş. İçinde: Özcan İ (Ed), Ağrı: Baş-Boyun ve orofasiyal ağrılar. İstanbul: Nobel Tıp Kitabevleri, 2000;17-32.
11Petersen S, Bergstrøm E, Brulin C. High prevalence of tiredness and pain in young schoolchildren. Scand J Public Health. 2003;3:367-74.
12Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, Bohnen AM, van Suijlekom-Smit LW, Passchier J, van der Wouden JC. Pain in children and adolescents: a common experience. Pain. 2000;87:51-8.
13Lundqvist C, Clench-Aas J, Hofoss D, Bartonova A. Selfreported headache in schoolchildren: parents underestimate their children’s headaches. Acta Paediatr. 2006;95:940-6.
14Lateef TM, Merikangas KR, He J, Kalaydjian A, Khoromi S, et al. Headache in a national sample of American children: prevalence and comorbidity. J Child Neurol. 2009;24:536-43.
15Henschke N, Harrison C, McKay D, Broderick C, Latimer J, et al. Mu sculoskeletal conditions in children andadolescents managed in Australian primary care. BMC Musculoskeletal Disorders. 2014;15:164.
16Roth-Isigkeit A, Thyen U, Raspe HH, Sto¨ ven H, Schmucker P. Reports of pain among German children and adolescents: an epidemiological study. Acta Paediatr. 2004;93:258-63.
17Taşdelen Bİ, Öztop DB, Özsoy SD, Poyrazoğlu HG, Ekmekçi S. Gerilim Tipi Baş Ağrısı Olan Çocuk ve Ergenlerde Psikopatoloji ve Yaşam Kalitesinin Değerlendirilmesi: 24. Ulusal Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kongresi, 9-12 Nisan 2014, Konya.
18Hergüner A, Arslan D, Güvenç O, Çimen D, Hergüner S. Organik Olmayan Göğüs Ağrısı Olan Ergenlerde Somatik Yakınmalar ve Psikiyatrik Belirtiler 24. Ulusal Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kongresi, 9-12 Nisan 2014, Konya.
19Şahin N, Kasap B, Kirli U, Yeniceri N, Topal Y. Assessment of anxiety-depression levels and perceptions of quality of life in adolescents with dysmenorrhea. Reproductive Health. 2018;15:13.
20Johnson TJ, Weaver MD, Borrero S, Davis EM, Myaskovsky L, et al. Association of Race and Ethnicity With Management of Abdominal Pain in the Emergency Department. Pedıatrıcs. 2013;132:851-8.
21Wang L, Haberland C, Thurm C, Bhattacharya J. Health Outcomes in US Children with Abdominal Pain at Major EmergencyDepartments Associated with Race and Socioeconomic Status. PLoS One. 2015;10:e0132758.
22Akova S, Yakut K, Yakut N, Güven Ş, Yazar AS, ve ark. Çocuk acil polikliniğine karın ağrısı şikayeti ile başvuran hastaların değerlendirilmesi Gaziantep Tıp Derg. 2013;19:60-4.
23Taşar S, Taşar MA, Güçer E, Güder L, Arıkan Fİ, et al. The Importance of the History and Laboratory Tests in the Differential Diagnosis of Acute Abdominal Pain Cases in the Pediatric Emergency Department. Turkish J Pediatr Dis. 2015;1:27-31.
24Sheridan DC, Meckler GD, Spiro DM, Koch KT, Hansen ML. Diagnostic Testing and Treatment of Pediatric Headache in the Emergency Department J Pediatr. 2013;163:1634-7.
25Massano D, Julliand S, Kanagarajah L, Gautier M, Vizeneux A, et al. Headache with focal neurologic signs in children at the emergency department. J Pediatr. 2014;165:376.
26Kabbouche M. Management of Pediatric Migraine Headache in the Emergency Room and Infusion Center. Headache. 2015;55:1365-70.
27Visits to Pediatric Emergency Departments for Headache Pain in Children Are on the Rise American Academy of Pediatrics 2016 Available at: https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Visits-to-Pediatric Emergency-Departments-for-Headache-Pain-in-Children-Are-on-the-Rise.aspx Accessed February 20,2018.
28Sim GY, Kim YD, Kim WS. The diagnostic types of headaches in the pediatric emergency department in Korea Journal of Biomedical and Translational Research. 2016;17:8-12.
29Hambrook JT, Kimball TR, Khoury P, Cnota J. Disparities exist in the emergency department evaluation of pediatric chest pain. Congenit Heart Dis. 2010;5:285-91.
30Drossner DM1, Hirsh DA, Sturm JJ, Mahle WT, Goo DJ, et al. Cardiac disease in pediatric patients presenting to a pediatric ED with chest pain. Am J Emerg Med. 2011;29:632-8.
31Brown JL, Hirsh DA, Mahle WT. Use of troponin as a screen for chest pain in the pediatric emergency department. Pediatr Cardiol. 2012;33:337-42.
32Şahin S. The Evaluation of Children Who Had Chest Pain on Pediatric Emergency Department. International Scholarly and Scientific Research &Innovation. 2016;10(5):1.
33Mohan S, Nandi D, Stephens P, M’Farrej M, Vogel RL, Bonafide C. Implementation of a Clinical Pathway for Chest Pain in a Pediatric Emergency Department. Pediatr Emerg Care. 2018;34:778-2.
34Kircher J, Drendel AL, Newton AS, Dulai S, Vandermeer B, Ali S. Pediatric musculoskeletal pain in the emergency department: a medical record review of practice variation. CJEM. 2014;16:449-57.
35Le May S, Ali S, Khadra C, Drendel AL, Trottier ED, et al. Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review. Pain Res Manag. 2016;2016:4809394.
36American College of Emergency Physicians. Clinical policy: critical issues for the initial evaluation and management of patients presenting with a chief complaint of nontraumatic acute abdominal pain. Ann Emerg Med. 2000;36:44.
37Zimmer KP, Walker A, Minkovitz CS. Epidemiology of pediatric emergency department use at an urban medical center. Pediatr Emerg Care. 2005;21:84-9.
38Çevik C, Tekir Ö. Acil Servis Başvurularının Tanı Kodları, Triyaj Ve Sosyo-Demografik Açıdan Değerlendirilmesi Balıkesir Sağlık Bilimleri Dergisi. 2014;3:102-7.
39Haraldstad K, Sørum R, Eide H, Natvig GK, Helseth S. Pain in children and adolescents: prevalence, impact on Daily life, and parents’ perception, a school survey. Scand J Caring Sci. 2011;25;27-36.
40Hankin BL, Abramson LY, Siler M. A prospective test of the hopelessness theory of depression in adolescence. Cognit Ther Res. 2001;25:607-32.
41Chitkara DK, Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in Western countries: a systematic review. Am J Gastroenterol. 2005;100:1868-75.
42Lewis DW, Ashwal S, Dahl G, Dorbad D, Hirtz D, et al. Practice parameter: eva¬luation of children and adolescents with recurrent headaches: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2002;59:490-8.
43Laurell K, Larsson B, Eeg-Olofsson O. Prevalence of hea¬dache in Swedish schoolchildren, with a focus on tension-type headache. Cephalalgia. 2004;24:380-8.
44Lin CH, Lin WC, Ho YJ, Chang JS. Children with Chest Pain Visiting the Emergency Department. Pediatr Neonatol. 2008;49:26-9.
45Khalilian MR, Moghadam AE, Torabizadeh M, Khalilinejad F, Moftakhar S. Pediatric and Adolescent Chest Pain: A Cross Sectional Study. Int J Pediatr. 2015;3:435-40.
46Tokgöz Y. Çocuk Acil Servisine Başvuran Adolesan Hastaların Sosyodemografik ve Klinik Özelliklerinin Değerlendirilmesi. Uzmanlık Tezi. Dokuz Eylül Üniversitesi Tıp Fakültesi Çocuk Sağlığı Ve Hastalıkları Anabilim Dalı. İzmir, 2006.
47Drosdzol A, Skrzypulec V. Dysmenorrhea in pediatric and adolescent gynaecology Ginekologia Polska. 2008;79:499-503.
48Gagua T, Tkeshelashvili B, Gagua D, Mchedlishvili N. Assessment of anxiety and depression in adolescents with primary dysmenorrhea: a case-control study. J Pediatr Adolesc Gynecol. 2013;26:350–4.
49Sanctis VD, Soliman A, Bernasconi S, Bianchin L, Bona G, et al. Primary Dysmenorrhea in Adolescents: Prevalence, Impact and Recent Knowledge Ped. Endocrinol Rev. 2015;13:465-73.
50Erenel ŞA, Şentürk A. Salık Meslek Lisesi Öğrencilerinin Dismenore Yaşama Durumları ve Dismenore ile Baş Etmeye Yönelik Uygulamaları. Hacettepe Hemşirelik Yüksekokulu Dergisi. 2007;2:48-60.
51Demirci D. Dismenore İle Baş Etmede Kullanılan Tamamlayıcı Ve Alternatif Tedavi Yöntemleri. Adnan Menderes Üniversitesi Sağlık Bilimleri Enstitüsü Doğum- Kadın Sağlığı Ve Hastalıkları Hemşireliği Yüksek Lisans Tezi. Aydın, 2017.
52Seham AF, Jameel H, Randa AQ, Ola AM, Oday AM, Luscombe G. Dysmenorrhea: Prevalence and Impact on Quality of Life among Young Adult Jordanian Females. J Pediatr Adolesc Gynecol. 2015;28:173-85.
53Carman KB, Arslantaş D, Ünsal A, Atay E, Ocal EE, et al. Menstrual headache in adolescences: Point prevalence and associated factors Pediatrics. International. 2018;60:576-80.
54Ahuja A. Impact of Dysmenorrhea on Quality of Life of Adolescent Girls of Chandigarh. J Child Adolesc Behav. 2016;4:295.
55Kasapçopur Ö. Eklem ağrısı ile başvuran çocukta ayırıcı tanı. Türk Aile Hek Derg. 2010;14:109-14.
56Zapata AL, Moraes AJ, Leone C, Doria-Filho U, Silva CA. Pain and musculoskeletal pain syndromes in adolescents. J Adolesc Health. 2006;38:769-71.
57Brun Sunblad GM, Saartok T, Engstrom LT. Prevalence and co-occurrence of self-rated pain and perceived health in school-children: age and gender differences. Eur J Pain. 2007;11:171-80.
58Munoz IC, Conesa AG, Meca JS. Prevalence of low back pain in children and adolescents: a meta-analysis BMC Pediatrics. 2013;13:14.
59Taxter AJ, Chauvin NA, Weiss PF. Diagnosis and Treatment of Low Back Pain in the Pediatric Population. Phys Sports¬med. 2014;42:94-104.
60Shehab D, Al-Jarallah K, Al-Ghareeb F, Sanaseeri S, Al-Fadhli M, et al. Is low-back pain prevalent among Kuwaiti children and adolescents? A governorate-based study. Med Princ Pract. 2004;13:142-6.
61Whittfield J, Legg SJ, Hedderley DI. Schoolbag weight and musculoskeletal symptoms in New Zealand secondary schools. Appl Ergon. 2005;36:193-8.
62De Luigi AJ. Low back pain in the adolescent athlete. Phys Med Rehabil Clin N Am. 2014;25:763-88.
63Clinch J, Eccleston C. Chronic musculoskeletal pain in children: assessment and management Rheumatology. 2009;48:466-74.