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G246(P) The increasing burden of chest pain presenting to the paediatric emergency department
  1. DT Sinton1,
  2. D Roland2,3
  1. 1Paediatric Emergency Department, Leicester Royal Infirmary, Leicester, UK
  2. 2Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospitals, Leicester, UK
  3. 3Social Science Applied to Healthcare Improvement Research (SAPPHIRE) Group, University of Leicester, Leicester, UK

Abstract

Aims While chest pain (CP) in children and young people can be a sign of a serious underlying cardiac or respiratory condition its cause tends to be musculo-skeletal or non-specific in origin. A perception of increasing ‘of the moment’ public healthcare demand led use to believe we were seeing increasing CP presentations of a non-cardiac origin. We aimed to describe the incidence of children presenting with chest pain to our Paediatric Emergency Department (PED) in the last decade.

Methods Data was extracted in a non-identifiable format from our department Emergency Department Information System (EDIS) using the search term “chest pain” in either the presenting complaint or discharge diagnosis categories in children aged 2–16 years. The resulting data was descriptively analysed.

Results During the 10 year period for which data was available a total of 1008 patients attended the PED with chest pain as a presenting complaint. The mean age of the population was 12 years. There was an increasing rate of presentations over the study period with 54 children in 2005 and 151 so far (January to October) in 2015, an increase from 0.175% of total attendances to 0.407% (Table 1). In spite of this increasing incidence we have observed a decrease in the number of children requiring onward referral from the PED (37% in 2005 vs. 19% in 2015) (Chi-Square 7.0881, p < 0.0076.) Coded diagnoses are displayed in Table 2.

Abstract G246(P) Table 1

Total and CP attenders by year including admission rate

Abstract G246(P) Table 2

Coded diagnosis

Conclusions CP is an increasing phenomenon in children and young people presenting to our PED. The cause of this is not clear however it is in keeping with the rising trend of presentations to emergency and urgent care services without an increasing overall conversion rate. We share this data to alert health service policy makers to the resource utilisation implications and how we can use this to design and co-create services in the future. This includes being reflective on whether our own emergency management of CP is evidence based.

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