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Published on: October 20, 2017
Morbidity and healthcare costs of vascular anomalies: a national study
Jina Kim1, Zhifei Sun2, Harold J Leraas3
1Duke University Medical Center, Box 3443, Durham, NC, 27710, USA. jina.kim1@duke.edu.
Insights
Children with vascular anomalies experience significant morbidities, with arteriovenous malformations (AVMs) incurring higher costs and mortality. Early recognition and prevention are key for cost-effective care.
Area of Science:
- Pediatric Medicine
- Vascular Surgery
- Health Economics
Background:
- Vascular anomalies are a diverse group of conditions affecting children.
- Understanding associated morbidities and healthcare costs is crucial for effective management.
Purpose of the Study:
- To define the morbidities and healthcare costs associated with modern medical care for pediatric vascular anomalies.
- To compare these factors across different types of vascular anomalies.
Main Methods:
- Analysis of the 2003-2009 Kids' Inpatient Database for pediatric patients (<21 years) with hemangioma, arteriovenous malformation (AVM), or lymphatic malformation (LM).
- Comparison of patient characteristics, hospital complications, and charges by anomaly type.
- Multivariable linear regression to identify predictors of hospital costs in AVM patients.
Main Results:
- 7485 pediatric inpatients with vascular anomalies were identified.
- Common complications included anemia (4.0%), sepsis (4.6%), and hypertension (2.4%).
- Arteriovenous malformations (AVMs) showed the highest mortality (1.0%) and median hospital charges (>$45,000), over double that of hemangiomas or lymphatic malformations (LMs).
Conclusions:
- Children with vascular anomalies face significant morbidity, primarily from blood loss and infection.
- Higher costs for AVM care are linked to increased mortality, complications, and procedural complexity.
- Cost-effective management necessitates prevention and early detection of both chronic and acute complications.
Purpose:
This study aimed to define morbidities and costs related to modern-day medical care for children with vascular anomalies.
Methods:
We reviewed the 2003-2009 Kids' Inpatient Database for pediatric patients (age < 21 years) hospitalized with hemangioma, arteriovenous malformation (AVM), or lymphatic malformation (LM). Patient characteristics, hospital complications, and hospital charges were compared by vascular anomaly type. Multivariable linear regression modeling was used to determine predictors of increasing hospital costs for patients with AVMs.
Results:
In total, 7485 pediatric inpatients with vascular anomalies were identified. Frequently associated complications included chronic anemia (4.0%), sepsis (4.6%), and hypertension (2.4%). Children with AVM had the highest rate of in-hospital mortality, compared to those with hemangiomas or LM (1.0% vs. 0.1% vs. 0.3%, p < 0.001). AVMs were also associated with the highest median hospital charge, more than twice the cost for hemangiomas or LM ($45,875 vs. $18,909 vs. $18,919; p < 0.001).
Conclusions:
There is a significant rate of morbidity in children with vascular anomalies, most often from blood loss and infection. The greater cost of AVM care may be related to the higher mortality rate, associated complications, and complexity of procedures required treating them. Cost-effective management of vascular anomalies should target prevention and the early recognition of both chronic comorbidities and acute complications.
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