Impact of bacterial meningitis-associated conditions on pediatric inpatient resource utilization.

OBJECTIVE: To define the epidemiology of systemic complications and focal infections associated with bacterial meningitis and quantify how the presence of such complications affects in-hospital healthcare resource utilization.
METHODS: Retrospective cohort study using administrative data from 27 children's hospitals. Children <18 years of age diagnosed with bacterial meningitis from 2001 to 2006 were eligible. The primary exposure of interest was the presence of a bacterial meningitis-associated condition, classified as either systemic complications (eg, sepsis), associated focal infections (eg, pneumonia) or both. The primary outcomes were total in-hospital charges and length of stay (LOS).
RESULTS: A total of 574 of 2319 (25%) of children had a systemic complication or an associated focal infection. Compared with children without complications, in-hospital charges were significantly higher in children with systemic complications (136% increase), associated focal infections (118% increase), and both conditions (351% increase). LOS was also significantly increased in those with systemic complications (by 72%), associated focal infections (by 78%), or both conditions (by 211%). The presence of systemic complications was more common in younger children while the presence of an associated focal infection was more common in older children.
CONCLUSIONS: Children with bacterial meningitis often have additional morbidity due to systemic complications or associated focal infections indicated by increase use of acute in-hospital resource utilization. The apparent increase in in-hospital morbidity related to these conditions should be considered in future evaluations of vaccine efficacy, novel therapeutics, and hospital resource allocation. (c) 2010 Society of Hospital Medicine.