Fever and neutropenia hospital discharges in children with cancer

A 2012 update

Emily L. Mueller, James Croop, Aaron Carroll

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Fever and neutropenia (FN) is a common precipitant for hospitalization among children with cancer, but hospital utilization trends are not well described. This study describes national trends for hospital discharges for FN among children with cancer for the year 2012, compared with the authors’ previous analysis from 2009. Data were analyzed from the Kids’ Inpatient Database (KID), an all-payer US hospital database, for 2012. Pediatric patients with cancer who had a discharge for FN were identified using age ≤19 years, urgent or emergent admit type, nontransferred, and a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for fever and neutropenia. The authors evaluated factors associated with a “short length of stay” (SLOS). Sampling weights were used to permit national inferences. In 2012, children with cancer accounted for 1.8% of pediatric hospital discharges (n = 120,675), with 12.2% (n = 13,456) of cancer-related discharges meeting FN criteria. Two fifths of FN discharges had a SLOS, which accounted for $91 million (2015 US$) in hospital charges. The majority had no serious infections; most common infections were viral infection (9.6%) or upper respiratory infection (9.6%). Factors significantly associated with SLOS included having a diagnosis of ear infection (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16–2.03), soft tissue sarcoma (OR = 1.47, CI: 1.10–1.95), and Hodgkin lymphoma (OR = 1.51, CI: 1.09–2.10), as compared with not having those diagnoses. SLOS admissions continue to be rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN. Implementation of risk stratification schemas to identify patients who meet low-risk criteria may decrease financial burden.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalPediatric Hematology and Oncology
DOIs
StateAccepted/In press - Feb 18 2016

Fingerprint

Neutropenia
Fever
Length of Stay
Neoplasms
Odds Ratio
International Classification of Diseases
Confidence Intervals
Infection
Hospitalization
Databases
Pediatrics
Hospital Charges
Cancer Care Facilities
Pediatric Hospitals
Virus Diseases
Hodgkin Disease
Respiratory Tract Infections
Sarcoma
Ear
Inpatients

Keywords

  • Adolescent
  • child
  • febrile neutropenia
  • health care surveys
  • oncology
  • supportive care
  • United States

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Fever and neutropenia hospital discharges in children with cancer : A 2012 update. / Mueller, Emily L.; Croop, James; Carroll, Aaron.

In: Pediatric Hematology and Oncology, 18.02.2016, p. 1-10.

Research output: Contribution to journalArticle

@article{3ec4f1d219f846749398789284598243,
title = "Fever and neutropenia hospital discharges in children with cancer: A 2012 update",
abstract = "Fever and neutropenia (FN) is a common precipitant for hospitalization among children with cancer, but hospital utilization trends are not well described. This study describes national trends for hospital discharges for FN among children with cancer for the year 2012, compared with the authors’ previous analysis from 2009. Data were analyzed from the Kids’ Inpatient Database (KID), an all-payer US hospital database, for 2012. Pediatric patients with cancer who had a discharge for FN were identified using age ≤19 years, urgent or emergent admit type, nontransferred, and a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for fever and neutropenia. The authors evaluated factors associated with a “short length of stay” (SLOS). Sampling weights were used to permit national inferences. In 2012, children with cancer accounted for 1.8{\%} of pediatric hospital discharges (n = 120,675), with 12.2{\%} (n = 13,456) of cancer-related discharges meeting FN criteria. Two fifths of FN discharges had a SLOS, which accounted for $91 million (2015 US$) in hospital charges. The majority had no serious infections; most common infections were viral infection (9.6{\%}) or upper respiratory infection (9.6{\%}). Factors significantly associated with SLOS included having a diagnosis of ear infection (odds ratio [OR] = 1.54, 95{\%} confidence interval [CI]: 1.16–2.03), soft tissue sarcoma (OR = 1.47, CI: 1.10–1.95), and Hodgkin lymphoma (OR = 1.51, CI: 1.09–2.10), as compared with not having those diagnoses. SLOS admissions continue to be rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN. Implementation of risk stratification schemas to identify patients who meet low-risk criteria may decrease financial burden.",
keywords = "Adolescent, child, febrile neutropenia, health care surveys, oncology, supportive care, United States",
author = "Mueller, {Emily L.} and James Croop and Aaron Carroll",
year = "2016",
month = "2",
day = "18",
doi = "10.3109/08880018.2015.1102998",
language = "English (US)",
pages = "1--10",
journal = "Pediatric Hematology and Oncology",
issn = "0888-0018",
publisher = "Informa Healthcare",

}

TY - JOUR

T1 - Fever and neutropenia hospital discharges in children with cancer

T2 - A 2012 update

AU - Mueller, Emily L.

AU - Croop, James

AU - Carroll, Aaron

PY - 2016/2/18

Y1 - 2016/2/18

N2 - Fever and neutropenia (FN) is a common precipitant for hospitalization among children with cancer, but hospital utilization trends are not well described. This study describes national trends for hospital discharges for FN among children with cancer for the year 2012, compared with the authors’ previous analysis from 2009. Data were analyzed from the Kids’ Inpatient Database (KID), an all-payer US hospital database, for 2012. Pediatric patients with cancer who had a discharge for FN were identified using age ≤19 years, urgent or emergent admit type, nontransferred, and a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for fever and neutropenia. The authors evaluated factors associated with a “short length of stay” (SLOS). Sampling weights were used to permit national inferences. In 2012, children with cancer accounted for 1.8% of pediatric hospital discharges (n = 120,675), with 12.2% (n = 13,456) of cancer-related discharges meeting FN criteria. Two fifths of FN discharges had a SLOS, which accounted for $91 million (2015 US$) in hospital charges. The majority had no serious infections; most common infections were viral infection (9.6%) or upper respiratory infection (9.6%). Factors significantly associated with SLOS included having a diagnosis of ear infection (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16–2.03), soft tissue sarcoma (OR = 1.47, CI: 1.10–1.95), and Hodgkin lymphoma (OR = 1.51, CI: 1.09–2.10), as compared with not having those diagnoses. SLOS admissions continue to be rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN. Implementation of risk stratification schemas to identify patients who meet low-risk criteria may decrease financial burden.

AB - Fever and neutropenia (FN) is a common precipitant for hospitalization among children with cancer, but hospital utilization trends are not well described. This study describes national trends for hospital discharges for FN among children with cancer for the year 2012, compared with the authors’ previous analysis from 2009. Data were analyzed from the Kids’ Inpatient Database (KID), an all-payer US hospital database, for 2012. Pediatric patients with cancer who had a discharge for FN were identified using age ≤19 years, urgent or emergent admit type, nontransferred, and a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for fever and neutropenia. The authors evaluated factors associated with a “short length of stay” (SLOS). Sampling weights were used to permit national inferences. In 2012, children with cancer accounted for 1.8% of pediatric hospital discharges (n = 120,675), with 12.2% (n = 13,456) of cancer-related discharges meeting FN criteria. Two fifths of FN discharges had a SLOS, which accounted for $91 million (2015 US$) in hospital charges. The majority had no serious infections; most common infections were viral infection (9.6%) or upper respiratory infection (9.6%). Factors significantly associated with SLOS included having a diagnosis of ear infection (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16–2.03), soft tissue sarcoma (OR = 1.47, CI: 1.10–1.95), and Hodgkin lymphoma (OR = 1.51, CI: 1.09–2.10), as compared with not having those diagnoses. SLOS admissions continue to be rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN. Implementation of risk stratification schemas to identify patients who meet low-risk criteria may decrease financial burden.

KW - Adolescent

KW - child

KW - febrile neutropenia

KW - health care surveys

KW - oncology

KW - supportive care

KW - United States

UR - http://www.scopus.com/inward/record.url?scp=84959045577&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959045577&partnerID=8YFLogxK

U2 - 10.3109/08880018.2015.1102998

DO - 10.3109/08880018.2015.1102998

M3 - Article

SP - 1

EP - 10

JO - Pediatric Hematology and Oncology

JF - Pediatric Hematology and Oncology

SN - 0888-0018

ER -