Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo-obstruction.
healthcare burden
inpatient admissions
motility
pediatric
pediatric gastroenterology
pseudo-obstruction
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
05
10
2019
revised:
18
11
2019
accepted:
22
11
2019
pubmed:
31
12
2019
medline:
20
1
2021
entrez:
31
12
2019
Statut:
ppublish
Résumé
Pediatric intestinal pseudo-obstruction is a rare disorder affecting gastrointestinal motility leading to chronic symptoms and hospitalizations. There is limited understanding of the epidemiology and healthcare burden. We analyzed data from Kids' Inpatient Database from 2016, which includes inpatient discharge records from US hospitals. ICD-10 codes were used to identify patients 0-18 years with pediatric intestinal pseudo-obstruction and comorbid conditions. Multivariable logistic regression and Wilcoxon rank-sum test were used. In 2016, there were 1671 inpatient discharges from US hospitals for patients 0-18 years of age with this diagnosis. The incidence of inpatient admission was 29/100 000 patients. After controlling for age, race, income status, and insurance, males vs females (adjusted odds ratio, aOR: 1.10; 95% CI: 0.94-1.28; P = .241) and caucasians vs other races (aOR: 1.55; 95% CI: 1.27-1.88; P < .001) were more likely to be admitted. Inpatient admissions incurred significant healthcare burden; median (inter quartile range IQR) cost of hospitalization of US$ 52 079 (US$ 23 530-120 961) and a median (IQR) length of stay of 6 days (3-14 days). Gastrostomy (32%) and ileostomy (12.6%) status appeared to incur lower healthcare burden. Parenteral nutrition, malnutrition, and central line/bloodstream infections resulted in higher healthcare burden. Pediatric intestinal pseudo-obstruction is a rare diagnosis with a high incidence of inpatient admissions and healthcare burden. An aggressive multidisciplinary management is crucial in reducing inpatient admissions in this cohort.
Sections du résumé
BACKGROUND
Pediatric intestinal pseudo-obstruction is a rare disorder affecting gastrointestinal motility leading to chronic symptoms and hospitalizations. There is limited understanding of the epidemiology and healthcare burden.
METHODS
We analyzed data from Kids' Inpatient Database from 2016, which includes inpatient discharge records from US hospitals. ICD-10 codes were used to identify patients 0-18 years with pediatric intestinal pseudo-obstruction and comorbid conditions. Multivariable logistic regression and Wilcoxon rank-sum test were used.
RESULTS
In 2016, there were 1671 inpatient discharges from US hospitals for patients 0-18 years of age with this diagnosis. The incidence of inpatient admission was 29/100 000 patients. After controlling for age, race, income status, and insurance, males vs females (adjusted odds ratio, aOR: 1.10; 95% CI: 0.94-1.28; P = .241) and caucasians vs other races (aOR: 1.55; 95% CI: 1.27-1.88; P < .001) were more likely to be admitted. Inpatient admissions incurred significant healthcare burden; median (inter quartile range IQR) cost of hospitalization of US$ 52 079 (US$ 23 530-120 961) and a median (IQR) length of stay of 6 days (3-14 days). Gastrostomy (32%) and ileostomy (12.6%) status appeared to incur lower healthcare burden. Parenteral nutrition, malnutrition, and central line/bloodstream infections resulted in higher healthcare burden.
CONCLUSIONS
Pediatric intestinal pseudo-obstruction is a rare diagnosis with a high incidence of inpatient admissions and healthcare burden. An aggressive multidisciplinary management is crucial in reducing inpatient admissions in this cohort.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13781Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
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