Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Trends in Incidence and Drug Therapy of Complex Regional Pain Syndrome in Children's Hospitals across the U.S.

M. Hoffart1,  Cara, F. Weiss2,  Pamela, J. Klink2,  Andrew, D. Sherry2,  D., Feudtner2,  Chris

The Children's Hospital of Philadelphia, Philadelphia, PA
The Children's Hospital of Philadelphia

Background:

The incidence of complex regional pain syndrome (CRPS) in hospitalized pediatric patients has been incompletely characterized and optimal treatment is debated.

Methods:

We conducted a retrospective observational study using Pediatric Health Information Systems (PHIS), an administrative database from 40 freestanding US children's hospitals. We determined admission temporal trends, patient characteristics, and drug therapy of children with a discharge diagnosis of CRPS between 1 January 2004 and 31 December 2009.

Results:

During this 6-year study, there were 848 hospitalizations for CRPS, of which 644 were an initial admission. The median age was 14 (IQR: 11, 16 years), and three-quarters of the patients were females. Seventy-five percent were white, 9% black, 2% Asian, 5% other, 9% unknown. Over time, there was a significant increase in cases of CRPS (from 18.6 cases per 100,000 admissions in 2004 to 49.2 cases per 100,000 admission in 2009; P = 0.03, by test for trend). The median length of stay for all 848 admissions was 5 days (IQR: 3, 9 days). Pharmacologic drug therapy during the initial admission included narcotics (490 patients, 78.4%), non-narcotic analgesics (410 patients, 65.6%), non-steroidal anti-inflammatory drugs (382 patients, 61.1%), psychotherapeutics (363 patients, 58.1%), sedative hypnotics (149 patients, 23.8%), and anesthetics such as ketamine (178 patients, 28.5%).

Conclusions:

The number of hospitalized children with CRPS has increased significantly over the last 6 years, due to either increasing incidence of this chronic pain syndrome, improved recognition and diagnosis, a shift in diagnostic coding, or some combination of these mechanisms. Regardless, the treatments received by these patients are diverse and warrant study regarding short and long term effectiveness.

Figure: Annual hospital admissions for children with CRPS.

To cite this abstract, please use the following information:
M. Hoffart, Cara, F. Weiss, Pamela, J. Klink, Andrew, D. Sherry, D., Feudtner, Chris; Trends in Incidence and Drug Therapy of Complex Regional Pain Syndrome in Children's Hospitals across the U.S. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1703
DOI: 10.1002/art.29468

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