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Shorter hospitalization trends among children with sickle cell disease
Author(s) -
Raphael Jean L.,
Mueller Brigitta U.,
Kowalkowski Marc A.,
Oyeku Suzette O.
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24065
Subject(s) - medicine , pediatrics , demographics , bivariate analysis , disease , multivariate analysis , bayesian multivariate linear regression , pediatric hospital , demography , emergency medicine , linear regression , statistics , mathematics , machine learning , sociology , computer science
Background Vaso‐occlusive crises (VOC) contribute to frequent hospitalizations among children with sickle cell disease (SCD). The objective of this study was to determine whether length of stay (LOS) has decreased for VOC hospitalizations between 1997 and 2009. Procedure We analyzed pediatric discharges (aged 0–18) with a primary or secondary diagnosis of SCD with crisis from the Kid's Inpatient Database (years 1997, 2003, and 2009), a nationally representative sample of pediatric hospital discharges. We conducted bivariate and multivariate, sample‐weighted linear regression analyses to determine associations between independent variables (patient demographics, hospital characteristics, co‐diagnoses, and procedures) and LOS. Results Both the number (22,661–21,741) and proportion of VOC hospitalizations (0.34–0.29%) among all pediatric hospitalizations marginally decreased between 1997 and 2009 ( P < 0.01). Mean LOS decreased from 4.59 to 4.21 days ( P < 0.01). For all study years, older age was the only socio‐demographic variable associated with longer LOS, controlling for other factors. Between 1997 and 2009, LOS decreased for all age categories, with the largest statistically significant reduction occurring among adolescents (5.69–4.76 days). Conclusions Nationally representative hospital data indicate modest but meaningful reductions in LOS for children with VOC over a 12‐year period. Adolescents who typically have the greatest disease severity showed the largest reduction in LOS. However, adolescents continue to account for a large proportion of inpatient stays for VOC. These findings illustrate that the adolescent period is a critical time in the lifespan for targeted intervention. Pediatr Blood Cancer 2012;59:679–684. © 2012 Wiley Periodicals, Inc.