Morbidity and healthcare costs of vascular anomalies: a national study.

Autor: Kim J; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA. jina.kim1@duke.edu., Sun Z; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA., Leraas HJ; Duke University School of Medicine, Durham, USA., Nag UP; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA., Benrashid E; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA., Allori AC; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA., Pabon-Ramos WM; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA., Rice HE; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA., Shortell CK; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA., Tracy ET; Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.
Jazyk: angličtina
Zdroj: Pediatric surgery international [Pediatr Surg Int] 2017 Feb; Vol. 33 (2), pp. 149-154. Date of Electronic Publication: 2016 Nov 22.
DOI: 10.1007/s00383-016-4007-x
Abstrakt: Purpose: This study aimed to define morbidities and costs related to modern-day medical care for children with vascular anomalies.
Methods: We reviewed the 2003-2009 Kids' Inpatient Database for pediatric patients (age < 21 years) hospitalized with hemangioma, arteriovenous malformation (AVM), or lymphatic malformation (LM). Patient characteristics, hospital complications, and hospital charges were compared by vascular anomaly type. Multivariable linear regression modeling was used to determine predictors of increasing hospital costs for patients with AVMs.
Results: In total, 7485 pediatric inpatients with vascular anomalies were identified. Frequently associated complications included chronic anemia (4.0%), sepsis (4.6%), and hypertension (2.4%). Children with AVM had the highest rate of in-hospital mortality, compared to those with hemangiomas or LM (1.0% vs. 0.1% vs. 0.3%, p < 0.001). AVMs were also associated with the highest median hospital charge, more than twice the cost for hemangiomas or LM ($45,875 vs. $18,909 vs. $18,919; p < 0.001).
Conclusions: There is a significant rate of morbidity in children with vascular anomalies, most often from blood loss and infection. The greater cost of AVM care may be related to the higher mortality rate, associated complications, and complexity of procedures required treating them. Cost-effective management of vascular anomalies should target prevention and the early recognition of both chronic comorbidities and acute complications.
Databáze: MEDLINE
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