The cost of hospitalizations for treatment of hemodialysis catheter-associated blood stream infections in children: a retrospective cohort study.

Autor: Wasik HL; Division of Pediatric Nephrology, SUNY Upstate Medical University, Physicians' Office Building 805, 725 Irving Avenue, Syracuse, NY, 13210, USA. wasikh@upstate.edu., Neu A; Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Warady B; Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA., Crawford B; Division of Pediatric Nephrology, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Richardson T; Children's Hospital Association, Lenexa, KS, USA., De Souza HG; Children's Hospital Association, Lenexa, KS, USA., Cardwell D; Division of Pediatric Nephrology, Children's Health Children's Medical Center, Dallas, TX, USA., Ruebner R; Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2023 Jun; Vol. 38 (6), pp. 1915-1923. Date of Electronic Publication: 2022 Nov 03.
DOI: 10.1007/s00467-022-05764-2
Abstrakt: Background: Hospitalization costs for treatment of hemodialysis (HD) catheter-associated blood stream infections (CA-BSI) in adults are high. No studies have evaluated hospitalization costs for HD CA-BSI in children or identified factors associated with high-cost hospitalizations.
Methods: We analyzed 160 HD CA-BSIs from the Standardizing Care to Improve Outcomes in Pediatric End-stage Kidney Disease (SCOPE) collaborative database linked to hospitalization encounters in the Pediatric Health Information System (PHIS) database. Charge-to-cost ratios were used to convert hospitalization charges reported in PHIS database to estimated hospital costs. Generalized linear mixed modeling was used to assess the relationship between higher-cost hospitalization (cost above 50 th percentile) and patient and clinical characteristics. Generalized linear regression models were used to assess differences in mean service line costs between higher- and lower-cost hospitalizations.
Results: The median (IQR) length of stay for HD CA-BSI hospitalization was 5 (3-10) days. The median (IQR) cost for HD CA-BSI hospitalization was $18,375 ($11,584-$36,266). ICU stay (aOR 5.44, 95% CI 1.62-18.26, p = 0.01) and need for a catheter procedure (aOR = 6.08, 95% CI 2.45-15.07, p < 0.001) were associated with higher-cost hospitalization.
Conclusions: Hospitalizations for HD CA-BSIs in children are often multiple days and are associated with substantial costs. Interventions to reduce CA-BSI may reduce hospitalization costs for children who receive chronic HD. A higher resolution version of the Graphical abstract is available as Supplementary information.
(© 2022. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
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