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BMC Cancer

, 15:388

Epidemiology, prevention and public health


BackgroundFever and neutropenia FN is a common complication of pediatric cancer treatment, but hospital utilization patterns for this condition are not well described.

MethodsData were analyzed from the Kids’ Inpatient Database KID, an all-payer US hospital database, for 2009. Pediatric FN patients were identified using: age ≤19 years, urgent or emergent admit type, non-transferred, and a combination of ICD-9-CM codes for fever and neutropenia. Sampling weights were used to permit national inferences.

ResultsPediatric cancer patients accounted for 1.5 % of pediatric hospital discharges in 2009 n = 110,967, with 10.1 % of cancer-related discharges meeting FN criteria n = 11,261. Two-fifths of FN discharges had a -short length of stay- SLOS of ≤3 days, which accounted for approximately $65.5 million in hospital charges. Upper respiratory infection 6.0 % and acute otitis media AOM 3.7 % were the most common infections associated with SLOS. Factors significantly associated with SLOS included living in the Midwest region OR = 1.65, 1.22–2.24 or West region OR 1.54, 1.11–2.14 versus Northeast, having a diagnosis of AOM OR = 1.39, 1.03–1.87 or viral infection OR = 1.63, 1.18–2.25 versus those without those comorbidities, and having a soft tissue sarcoma OR = 1.47, 1.05–2.04, Hodgkin lymphoma OR = 2.33, 1.62–3.35, or an ovarian-testicular tumor OR = 1.76, 1.05–2.95 compared with patients without these diagnoses.

ConclusionFN represents a common precipitant for hospitalizations among pediatric cancer patients. SLOS admissions are rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN.

Key wordsChild Adolescent Oncology Supportive care Febrile neutropenia AbbreviationsAOMAcute otitis media

AHRQAgency for Healthcare Research and Quality

CCSClinical Classification Software

EDEmergency department

FNFever and neutropenia

KIDKids’ Inpatient Database

ICD-9-CMInternational Classification of Diseases, ninth revision, Clinical Modification

LOSLength of stay

SLOSShort length of stay

USUnited States

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Autor: Emily L. Mueller - Kelly J. Walkovich - Rajen Mody - Achamyeleh Gebremariam - Matthew M. Davis


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