Identifying multimorbidity patterns of non-communicable diseases in paediatric inpatients: a cross-sectional study in Shanghai, China

Objectives To enhance the understanding of non-communicable disease (NCD) multimorbidity in children who are inpatients by delineating the characteristics of and identifying patterns among paediatric inpatients with multimorbidity in China. Design Cross-sectional study. Setting Paediatric wards (n=17) in Pudong New Area, Shanghai, China. Participants A total of 193 432 paediatric inpatients in the electronic health record systems of 17 hospitals from 2011 to 2016 participated in the study, and 91 004 children with NCDs were extracted and classified based on International Classification of Diseases, 10th version codes. Main outcome measures Number of the NCDs and multimorbidity patterns of the paediatric inpatients. Results In total, 47.05% (95% CI 46.83 to 47.27) of the paediatric inpatients had one or more chronic diseases, and 16.30% (95% CI 16.14 to 16.46) had multimorbidity. Congenital anomalies accounted for 19.43% (95% CI 19.25 to 19.61) of the principal diagnoses among the paediatric inpatients. Five common multimorbidity patterns were identified: a neurological-respiratory cluster, a neurological-respiratory-ear cluster, a cardiovascular-circulatory cluster, a genitourinary cluster (boy group) and a musculoskeletal-connective cluster (10-18 years age group). Conclusions Multimorbidity in paediatric inpatients suggests that decisions about reasonable allocation of paediatric inpatient resources should be fully considered. Multimorbidity patterns in paediatric inpatients revealed that prevention, including innovative treatments targeting children, should be further studied.

Automated summary

This cross-sectional study conducted in paediatric wards in Shanghai, China, involving 193,432 paediatric inpatients from 17 hospitals, aimed to explore the characteristics and patterns of multimorbidity in children with non-communicable diseases. The study found that 47.05% of paediatric inpatients had chronic diseases, with 16.30% having multimorbidity, and identified five common multimorbidity patterns among them, highlighting the importance of considering appropriate resource allocation and preventive strategies for children with multiple chronic conditions.