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Risk Factors, Geographic Distribution, and Healthcare Burden of Symptomatic Congenital Cytomegalovirus Infection in the United States: Analysis of a Nationally Representative Database, 2000-2012.
Inagaki, Kengo; Blackshear, Chad; Palmer, April; Hobbs, Charlotte V.
Afiliação
  • Inagaki K; Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS. Electronic address: kinagaki@umc.edu.
  • Blackshear C; Department of Data Science, University of Mississippi Medical Center, Jackson, MS.
  • Palmer A; Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS.
  • Hobbs CV; Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS.
J Pediatr ; 199: 118-123.e1, 2018 08.
Article em En | MEDLINE | ID: mdl-29706491
OBJECTIVE: To assess risk factors, geographic distribution, length of stay, and total charges per case of symptomatic congenital cytomegalovirus infection (cCMV). STUDY DESIGN: We performed retrospective analyses of serial cross-sectional data using the Kids' Inpatient Database, a nationally representative sample of US pediatric hospital discharges, from 2000, 2003, 2006, 2009, and 2012. Symptomatic cCMV was identified via use of the International Classification of Diseases, Ninth Revision, Clinical Modification code 771.1 among records with in-hospital birth that were accompanied by 1 or more characteristic symptoms. Demographic characteristics were compared with multivariable logistic regression. Temporal trend was assessed using linear regression. Charges were adjusted for inflation to 2012 US dollars. RESULTS: We identified 1349 cases of symptomatic cCMV (SE 56). Symptomatic cCMV was associated with non-Hispanic black race (OR 1.70; 95% CI 1.37-2.10), government-sponsored insurance (OR 1.95; 95% CI 1.34-2.83), and birth in the American South and West (OR 1.68, 95% CI 1.35-2.09 and OR 1.61, 95% CI 1.23-2.09, respectively). In-hospital mortality and preterm birth rate ranged from 3.2%-6.8% and 50.4%-59.2%, respectively, without temporal changes. The geometric mean of total charges per case doubled from $45 771 (SE $8509) in 2000 to $89 846 (SE $10 358) in 2006 (P = .002) but did not change from 2006 to 2012. Length of stay in days was 15 (IQR 8-22) in 2000, 27 (IQR, 9-51) in 2009, and 18 (IQR, 8-47) in 2012. CONCLUSIONS: Symptomatic cCMV was associated with non-Hispanic black race, low socioeconomic status, and birth in the American South and West and resulted in substantial healthcare burden.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preços Hospitalares / Infecções por Citomegalovirus / Hospitalização Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preços Hospitalares / Infecções por Citomegalovirus / Hospitalização Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos