PURPOSE: Congenital obstructive uropathy (COU) is a leading cause of pediatric chronic kidney disease (CKD). Urinary tract infections (UTIs) pose a risk for ascending infections and CKD in patients with COU. We evaluated the impact of comorbid UTIs on hospital charges and length of stay (LOS) for pediatric COU discharges. MATERIALS AND METHODS: The study sample (n = 2832) was drawn from the 2003 and 2006 US Healthcare Cost and Utilization Project Kids' Inpatient Database. Data were analyzed using logistic and linear regression. RESULTS: Comorbid UTIs complicated 6.7% of COU discharges, and were most common in patients with posterior urethral valves (15.7% of discharges). Comorbid UTIs increased mean charges by $7910 (95% confidence interval (CI) $4770-$11,040; p < 0.001) and prolonged mean LOS by 2.66 days (95% CI 2.03-3.29; p < 0.001) compared to COU discharges without UTI. After controlling for LOS, charges for COU with a secondary diagnosis of UTI were no longer significantly higher. Mean charges in inflation-adjusted dollars increased by $2710, a 15.8% increase unexplained by covariate diagnoses and procedures. CONCLUSIONS: Comorbid UTIs contribute significantly to inpatient charges for COU, by prolonging LOS.
PURPOSE:Congenital obstructive uropathy (COU) is a leading cause of pediatric chronic kidney disease (CKD). Urinary tract infections (UTIs) pose a risk for ascending infections and CKD in patients with COU. We evaluated the impact of comorbid UTIs on hospital charges and length of stay (LOS) for pediatric COU discharges. MATERIALS AND METHODS: The study sample (n = 2832) was drawn from the 2003 and 2006 US Healthcare Cost and Utilization Project Kids' Inpatient Database. Data were analyzed using logistic and linear regression. RESULTS: Comorbid UTIs complicated 6.7% of COU discharges, and were most common in patients with posterior urethral valves (15.7% of discharges). Comorbid UTIs increased mean charges by $7910 (95% confidence interval (CI) $4770-$11,040; p < 0.001) and prolonged mean LOS by 2.66 days (95% CI 2.03-3.29; p < 0.001) compared to COU discharges without UTI. After controlling for LOS, charges for COU with a secondary diagnosis of UTI were no longer significantly higher. Mean charges in inflation-adjusted dollars increased by $2710, a 15.8% increase unexplained by covariate diagnoses and procedures. CONCLUSIONS: Comorbid UTIs contribute significantly to inpatient charges for COU, by prolonging LOS.
Authors: Jennifer K Plichta; Casey J Holmes; Vanessa Nienhouse; Michelle Puszynski; Xiang Gao; Qunfeng Dong; Huaiying Lin; James Sinacore; Michael Zilliox; Evelyn Toh; David E Nelson; Richard L Gamelli; Katherine A Radek Journal: Crit Care Med Date: 2017-06 Impact factor: 7.598