Characteristics and Outcomes of Pediatric Heart Failure-Related Emergency Department Visits in the United States: A Population-Based Study - 31/01/18
, Matthew J. O'Connor, MD 1, 2, Kimberly Y. Lin, MD 1, 2, Lihai Song, MS 1, Heather Griffis, PhD 1, Christopher E. Mascio, MD 1, 2, Pirouz Shamszad, MD 1, 2, Aaron Donoghue, MD, MSCE 1, Chitra Ravishankar, MD 1, 2, Robert E. Shaddy, MD 4, Joseph W. Rossano, MD, MS 1, 2, 3Abstract |
Objectives |
To describe the frequency, characteristics, and outcomes of heart failure-related emergency department (ED) visits in pediatric patients. We aimed to test the hypothesis that these visits are associated with higher admission rates, mortality, and resource utilization.
Study design |
A retrospective analysis of the Nationwide Emergency Department Sample for 2010 of patients ≤18 years of age was performed to describe ED visits with and without heart failure. Cases were identified using International Classification of Disease, Ninth Revision, Clinical Modification codes and assessed for factors associated with admission, mortality, and resource utilization.
Results |
Among 28.6 million pediatric visits to the ED, there were 5971 (0.02%) heart failure-related cases. Heart failure-related ED patients were significantly more likely to be admitted (59.8% vs 4.01%; OR 35.3, 95% CI 31.5-39.7). Among heart failure-related visits, admission was more common in patients with congenital heart disease (OR 5.0, 95% CI 3.3-7.4) and in those with comorbidities including respiratory failure (OR 78.3, 95% CI 10.4-591) and renal failure (OR 7.9, 95% CI 1.7-36.3). Heart failure-related cases admitted to the hospital had a higher likelihood of death than nonheart failure-related cases (5.9% vs 0.32%, P < .001). Factors associated with mortality included respiratory failure (OR 4.5, 95% CI 2.2-9.2) and renal failure (OR 7.8, 95% CI 2.9-20.7). Heart failure-related ED visits were more expensive than nonheart failure-related ED visits ($1460 [IQR $861-2038] vs $778 [IQR $442-1375] [P < .01].)
Conclusions |
Heart failure-related visits represent a minority of pediatric ED visits but are associated with increased hospital admission and resource utilization.
Le texte complet de cet article est disponible en PDF.Keywords : resource utilization, heart failure
Abbreviations : CHD, ED, HCUP, ICD-9-CM, NEDS
Plan
| The authors declare no conflicts of interest. |
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| A portion of this study was presented as a poster at the American Academy of Pediatrics National Conference, October 24-25, 2015, Washington, DC, and at the Children's Hospital of Philadelphia (CHOP) Cardiology Conference, February 24-28, 2016, Orlando, Florida. |
Vol 193
P. 114 - février 2018 Retour au numéro
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