Background and Aims:
Recent technological advances modified pediatric patient profile leading to an increasing number of children and adolescents with complex medical conditions (CMC). This study aimed to determine the proportion of hospitalizations of patients with CMC in a general pediatric Brazilian ward and its burden. 

Methods: 
We conducted a retrospective single-center cohort study in a general pediatric ward in Brazil. We analyzed 1630 discharge summaries and 77 medical records from patients under 16 years-old admitted in 2015. The underlying disease, number of admissions in one year, length of stay (LOS), need of intensive care unit (ICU) and days in ICU were used to compare CMC and non-CMC groups. 

Results: 
CMC patients represented 3.8% of all patients admitted (n=54). They were responsible for 8.3% of overall ICU admissions, occupying 28% of the total number of days in the ICU. The CMC group had significantly more one-year-readmissions than the non-CMC group (31.5% vs. 7.7%, respectively; p<0.0001). Likewise, CMC patients presented a significantly longer median total LOS (5.0 vs.3.0; p <0.0001) and median ICU LOS (10.0 vs.3.0; p <0.05).

Conclusions: 
Despite being the minority of admissions, CMC patients had a significant burden on our pediatric service. Accordingly, we propose that inpatient and outpatient care must be improved by bettering multidisciplinary capacitation. Besides, it is essential to establish specific assistance protocols and government policies focusing in diminish needs and LOS of hospitalization and ICU.

BURDEN OF CHILDREN WITH COMPLEX MEDICAL CONDITIONS IN A GENERAL PAEDIATRIC WARD IN BRAZIL