Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical characteristics and nursing diagnoses of pediatric patients hospitalized with inflammatory bowel disease: a single-center retrospective study in South Korea

  • Sung-Yoon Jo (College of Nursing, Seoul National University) ;
  • Kyung-Sook Bang (College of Nursing.The Research Institute of Nursing Science, Seoul National University)
  • Received : 2023.05.09
  • Accepted : 2023.06.26
  • Published : 2023.07.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study aimed to identify clinical characteristics of South Korean pediatric inflammatory bowel disease (IBD) in a children's hospital over the past 5 years, with a specific focus on comparing the features observed between Crohn's disease (CD) and ulcerative colitis (UC). Additionally, it aimed to examine the nursing diagnoses given to patients. Methods: This retrospective study analyzed the medical records of Korean pediatric patients under 18 years of age who were diagnosed with IBD and hospitalized at a children's hospital in Seoul, South Korea, from January 2017 to December 2021. Results: The number of pediatric patients diagnosed with IBD steadily increased. This finding was particularly prominent for CD patients, the majority of whom were male. Pediatric patients with CD had significantly higher rates of abdominal pain and perianal lesions, while pediatric patients with UC had a higher rate of bloody stool. Laboratory findings indicated that CD patients had higher levels of inflammatory markers and lower albumin levels than UC patients. The nursing diagnoses given during hospitalization mostly related to safety and protection, physical comfort, and gastrointestinal function. Conclusion: This study provides insights into Korean pediatric IBD patients, enabling early detection and the development of nursing intervention strategies. From a comprehensive perspective, nursing care should not only address patients' physical needs but also their psychosocial needs.

Keywords

References

  1. Guo X, Huang C, Xu J, Xu H, Liu L, Zhao H, et al. Gut microbiota is a potential biomarker in inflammatory Bowel disease. Frontiers in Nutrition. 2022;8:818902. https://doi.org/10.3389/fnut.2021.818902 
  2. Benchimol EI, Fortinsky KJ, Gozdyra P, Van den Heuvel M, Van Limbergen J, Griffiths AM. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflammatory Bowel Diseases. 2011;17(1):423-439. https://doi.org/10.1002/ibd.21349 
  3. Kuenzig ME, Fung SG, Marderfeld L, Mak JWY, Kaplan GG, Ng SC, et al. Twenty-first century trends in the global epidemiology of pediatric-onset inflammatory bowel disease: systematic review. Gastroenterology. 2022;162(4):1147-1159.e4. https://doi.org/10.1053/j.gastro.2021.12.282 
  4. Ye Y, Manne S, Treem WR, Bennett D. Prevalence of inflammatory bowel disease in pediatric and adult populations: recent estimates from large national databases in the United States, 2007-2016. Inflammatory Bowel Diseases. 2020;26(4):619-625. https://doi.org/10.1093/ibd/izz182 
  5. Ashton JJ, Barakat FM, Barnes C, Coelho TAF, Batra A, Afzal NA, et al. Incidence and prevalence of paediatric inflammatory bowel disease continues to increase in the South of England. Journal of Pediatric Gastroenterology and Nutrition. 2022;75(2):e20-e24. https://doi.org/10.1097/mpg.0000000000003511 
  6. Kim BJ, Song SM, Kim KM, Lee YJ, Rhee KW, Jang JY, et al. Characteristics and trends in the incidence of inflammatory bowel disease in Korean children: a single-center experience. Digestive Diseases and Sciences. 2010;55(7):1989-1995. https://doi.org/10.1007/s10620-009-0963-5 
  7. Hong SJ, Cho SM, Choe BH, Jang HJ, Choi KH, Kang B, et al. Characteristics and incidence trends for pediatric inflammatory bowel disease in Daegu-Kyungpook province in Korea: a multicenter study. Journal of Korean Medical Science. 2018;33(18):e132. https://doi.org/10.3346/jkms.2018.33.e132 
  8. Choe JY, Choi S, Song KH, Jang HJ, Choi KH, Yi DY, et al. Incidence and prevalence trends of pediatric inflammatory bowel disease in the Daegu-Kyungpook province from 2017 to 2020. Frontiers in Pediatrics. 2022;9:810173. https://doi.org/10.3389/fped.2021.810173 
  9. Fuller MK. Pediatric inflammatory bowel disease: special considerations. Surgical clinics of North America. 2019;99(6):1177-1183. https://doi.org/10.1016/j.suc.2019.08.008 
  10. Aniwan S, Harmsen WS, Tremaine WJ, Loftus EV Jr. Incidence of inflammatory bowel disease by race and ethnicity in a population-based inception cohort from 1970 through 2010. Therapeutic Advances in Gastroenterology. 2019;12:1756284819827692. https://doi.org/10.1177/1756284819827692 
  11. Duricova D, Burisch J, Jess T, Gower-Rousseau C, Lakatos PL; ECCO-EpiCom. Age-related differences in presentation and course of inflammatory bowel disease: an update on the population-based literature. Journal of Crohn's & Colitis. 2014;8(11):1351-1361. https://doi.org/10.1016/j.crohns.2014.05.006 
  12. Cai Z, Wang S, Li J. Treatment of inflammatory bowel disease: a comprehensive review. Frontiers in Medicine. 2021;8:765474. https://doi.org/10.3389/fmed.2021.765474 
  13. Yu YR, Rodriguez JR. Clinical presentation of Crohn's, ulcerative colitis, and indeterminate colitis: symptoms, extraintestinal manifestations, and disease phenotypes. Seminars in Pediatric Surgery. 2017;26(6):349-355. https://doi.org/10.1053/j.sempedsurg.2017.10.003 
  14. Lee HA, Suk JY, Choi SY, Kim ER, Kim YH, Lee CK, et al. Characteristics of pediatric inflammatory bowel disease in Korea: comparison with EUROKIDS data. Gut and Liver. 2015;9(6):756-760. https://doi.org/10.5009/gnl14338 
  15. Lee NY, Park JH. Clinical features and course of Crohn disease in children. Journal of the Korean Society of Gastrointestinal Endoscopy. 2007;34(4):193-199. 
  16. Park S, Kang B, Kim S, Choi S, Suh HR, Kim ES, et al. Comparison between pediatric Crohn's disease and ulcerative colitis at diagnosis in Korea: results from a multicenter, registry-based, inception cohort study. Gut and Liver. 2022;16(6):921-929. https://doi.org/10.5009/gnl210488 
  17. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806-808. https://doi.org/10.1136/bmj.39335.541782.ad 
  18. Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean Journal of Pediatrics. 2018;61(5):135-149. https://doi.org/10.3345/kjp.2018.61.5.135 
  19. Herdman TH, Kamitsuru S, Lopes CT. NANDA International Nursing diagnoses: definitions and classification 2021-2023. 12th ed. Thieme; 2021. p. 187-574. 
  20. Seo JK, Yeon KM, Chi JG. Inflammatory bowel disease in chidren--clinical, endoscopic, radiologic and histopathologic investigation. Journal of Korean Medical Science. 1992;7(3):221-235. https://doi.org/10.3346/jkms.1992.7.3.221 
  21. Malmborg P, Grahnquist L, Lindholm J, Montgomery S, Hildebrand H. Increasing incidence of paediatric inflammatory bowel disease in Northern Stockholm county, 2002-2007. Journal of Pediatric Gastroenterology and Nutrition. 2013;57(1):29-34. https://doi.org/10.1097/mpg.0b013e31828f21b4 
  22. Wang XQ, Zhang Y, Xu CD, Jiang LR, Huang Y, Du HM, et al. Inflammatory bowel disease in Chinese children: a multicenter analysis over a decade from Shanghai. Inflammatory Bowel Diseases. 2013;19(2):423-428. https://doi.org/10.1097/mib.0b013e318286f9f2 
  23. Kugathasan S, Judd RH, Hoffmann RG, Heikenen J, Telega G, Khan F, et al.; Wisconsin Pediatric Inflammatory Bowel Disease Alliance. Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: a statewide population-based study. Journal of Pediatrics. 2003;143(4):525-531. https://doi.org/10.1067/s0022-3476(03)00444-x 
  24. El Mouzan MI, Al Edreesi MH, Al-Hussaini AA, Saadah OI, Al Qourain AA, Al Mofarreh MA, et al. Nutritional status of children with inflammatory bowel disease in Saudi Arabia. World Journal of Gastroenterology. 2016;22(5):1854-1858. https://doi.org/10.3748/wjg.v22.i5.1854 
  25. Arai K, Kunisaki R, Kakuta F, Hagiwara SI, Murakoshi T, Yanagi T, et al. Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry. Intestinal Research. 2020;18(4):412-420. https://doi.org/10.5217/ir.2019.00130 
  26. Ishige T. Growth failure in pediatric onset inflammatory bowel disease: mechanisms, epidemiology, and management. Translational Pediatrics. 2019;8(1):16-22. https://doi.org/10.21037/tp.2018.12.04 
  27. Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Archives of Disease in Childhood. 2003;88(11):995-1000. https://doi.org/10.1136/adc.88.11.995 
  28. Yap J, Wesley A, Mouat S, Chin S. Paediatric inflammatory bowel disease in New Zealand. New Zealand Medical Journal. 2008;121(1283):19-34. 
  29. da Silva BC, Lyra AC, Rocha R, Santana GO. Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis. World Journal of Gastroenterology. 2014;20(28):9458-9467. https://doi.org/10.3748/wjg.v20.i28.9458 
  30. Alper A, Zhang L, Pashankar DS. Correlation of erythrocyte sedimentation rate and C-reactive protein with pediatric inflammatory bowel disease activity. Journal of Pediatric Gastroenterology and Nutrition. 2017;65(2):e25-e27. https://doi.org/10.1097/mpg.0000000000001444 
  31. Day AS, Hamilton D, Leach ST, Lemberg DA. Inflammatory markers in children with newly diagnosed inflammatory bowel disease. Journal of Gastroenterology and Hepatology Research. 2017;6(2):2329-2332.  https://doi.org/10.17554/j.issn.2224-3992.2017.06.647
  32. Khaki-Khatibi F, Qujeq D, Kashifard M, Moein S, Maniati M, Vaghari-Tabari M. Calprotectin in inflammatory bowel disease. Clinica Chimica Acta. 2020;510:556-565. https://doi.org/10.1016/j.cca.2020.08.025 
  33. Pathirana WGW, Chubb SP, Gillett MJ, Vasikaran SD. Faecal Calprotectin. Clinical Biochemist Reviews. 2018;39(3):77-90. 
  34. Roca M, Rodriguez Varela A, Carvajal E, Donat E, Cano F, Armisen A, et al. Fecal calprotectin in healthy children aged 4-16 years. Scientific Reports. 2020;10(1):20565. https://doi.org/10.1038/s41598-020-77625-7 
  35. Konikoff MR, Denson LA. Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflammatory Bowel Diseases. 2006;12(6):524-534. https://doi.org/10.1097/00054725-200606000-00013