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Children hospitalized with lower extremity fractures in the United States in 2006: a population-based approach
1University of Iowa, Department of Orthopaedics and Rehabilization, 200 Hawkins Drive, Iowa City, IA 52254, USA.
Insights
In 2006, boys were more likely than girls to be hospitalized for lower extremity fractures. Rural and non-teaching hospitals showed higher mortality risks for pediatric fracture patients.
Area of Science:
- Pediatric Orthopedics
- Health Services Research
- Epidemiology
Background:
- Lower extremity fractures are a common pediatric injury.
- Understanding hospitalization patterns is crucial for resource allocation and injury prevention.
Purpose of the Study:
- To analyze the demographic and hospitalization characteristics of children with lower extremity fractures in the U.S. in 2006.
- To identify factors associated with length of stay, charges, and mortality.
Main Methods:
- Utilized the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID).
- Included children aged 0-20 years with lower extremity fractures (ICD-9 codes 820-829).
- Analyzed demographic and hospitalization data using chi-square testing and unbalanced analysis of variance.
Main Results:
- Boys comprised a larger proportion of cases; 53% had private insurance.
- The majority of hospitalizations occurred in urban (93%) and teaching (66%) hospitals.
- Infants had the longest average length of stay (5.46 days); older patients incurred higher charges ($41,907).
- Mortality risk was significantly higher in rural and non-teaching hospitals.
Conclusions:
- This study highlights key demographic and hospitalization trends for pediatric lower extremity fractures in 2006.
- Findings suggest a need for targeted interventions to reduce injury and improve outcomes, especially in rural and non-teaching settings.
- Further research is needed to establish causality for observed mortality disparities.
Objective:
The purpose of this study was to examine the demographic and hospitalization characteristics of children hospitalized with lower extremity fractures in the United States in 2006.
Methods:
Children aged 0 to 20 years with a diagnosis of lower extremity fracture in the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) were included. Lower extremity fractures were defined by International Classification of Diseases, 9th Revision, Clinical Modification codes 820-829 under "Injury and Poisoning (800-999)." Patient demographic and hospitalization-related data were analyzed by chi-square testing and unbalanced analysis of variance.
Results:
There were more boys than girls with lower extremity fractures and 53% had private insurance as their primary payer. About one half of the children were between the ages of 13 and 20 years, but all ages were represented from age 0 to 20. White children accounted for 56%. Urban hospitalizations accounted for 93% of cases and 66 percent of admissions were to teaching hospitals. All patients had an average length of stay (LOS) 4.04 days, and infant patients had the longest average LOS of 5.46 days. The average number of diagnoses per patient was 3.07, and the average number of procedures per patient was 2.21. The average charge per discharge was $35,236, and the oldest patients had the largest average charge of $41,907. The average number of comorbidities increased with increasing patient age. There was a 55.6% greater mortality risk in non-teaching hospitals than in teaching hospitals and there was at least ten times the mortality risk in rural hospitals than in urban hospitals.
Conclusions:
This study provides an understanding of the demographic and hospitalization characteristics of children with lower extremity fractures in the United States in 2006. This information may be useful in implementing measures to help prevent similar injuries in the future. Further research is required to determine causality of the associations found including increased mortality risk for this population at rural and non-teaching hospitals.
