Citation

Moreau JF, Fink EL, Hartman ME, Angus DC, Bell MJ, Linde-Zwirble WT, Watson RS. Pediatr. Crit. Care Med. 2013; 14(8): 801-810.

Affiliation

1Department of Critical Care Medicine, the CRISMA Center (Clinical Research, Investigation, and Systems Modeling of Acute Illness), University of Pittsburgh, Pittsburgh, PA. 2Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, the Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA. 3Division of Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO. 4ZD Associates LLC, Perkasie, PA.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/PCC.0b013e31828aa71f

PMID

23842588

Abstract

OBJECTIVES:: Although neurological disorders are among the most serious acute pediatric illnesses, epidemiologic data are scarce. We sought to determine the scope and outcomes of children with these disorders in the United States. DESIGN:: Retrospective cohort study. SETTING:: All nonfederal hospitals in 11 states encompassing 38% of the U.S. pediatric population. PATIENTS:: Children 29 days to 19 years old hospitalized in 2005. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Using International Classification of Diseases, 9th Revision, Clinical Modification, codes, we identified admissions with neurological diagnoses, analyzed patient and hospitalization characteristics, and generated age- and sex-adjusted national estimates. Of 960,020 admissions in the 11 states, 10.7% (103,140) included a neurological diagnosis, which yields a national estimate of 273,900 admissions of children with neurological diagnoses. The most common were seizures (53.9%) and traumatic brain injury (17.3%). Children with neurological diagnoses had nearly three times greater ICU use than other hospitalized children (30.6% vs 10.6%, p < 0.001). Neurological diagnoses were associated with nearly half of deaths (46.2%, n = 1,790). Among ICU patients, children with neurological diagnoses had more than three times the mortality of other patients (4.8% vs1.5%, p < 0.001). Children with neurological diagnoses had a significantly longer median hospital length of stay than other children (3 d [1, 5] vs 2 d [2, 4], p < 0.001) and greater median hospital costs ($4,630 [$2,380, $9,730] vs $2,840 [$1,520, $5,550], p < 0.001). CONCLUSIONS:: Children with neurological diagnoses account for a disproportionate amount of ICU stays and deaths compared with children hospitalized for other reasons.

Language: en