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Pediatric Septic Arthritis and Osteomyelitis in the USA: A National KID Database Analysis
Gabriella Safdieh1, Jason Silberman2, Joseph Nguyen3
1Parsley Health, 33 Irving Place, New York, NY 10003 USA.
Insights
Pediatric osteomyelitis and combined infections incidence rose, while septic arthritis remained stable. Despite consistent length of stay, healthcare costs for these pediatric infections significantly increased from 1997 to 2012.
Area of Science:
- Pediatric infectious diseases
- Healthcare epidemiology
- Musculoskeletal infections
Background:
- Osteoarticular infections in children may be rising.
- Understanding trends in pediatric osteomyelitis and septic arthritis is crucial.
Purpose of the Study:
- To analyze changes in incidence rates, costs, and length of stay for pediatric osteomyelitis, septic arthritis, and combined infections.
- To compare current pediatric infection rates with previous findings.
Main Methods:
- Utilized the Kids' Inpatient Database (KID) from 1997-2012 for pediatric discharge records.
- Calculated yearly incidence rates using US census data.
- Employed trend tests to assess changes in length of stay and inflation-adjusted costs over time.
Main Results:
- Osteomyelitis incidence increased from 7.9 to 10.5 per 100,000; combined infections rose from 0.8 to 1.3 per 100,000.
- Septic arthritis incidence remained stable at approximately 5.2-5.3 per 100,000.
- Median length of stay showed no significant change, but median in-hospital costs increased substantially for all infection types.
Conclusions:
- Pediatric septic arthritis incidence is stable, while osteomyelitis and combined infection rates have increased.
- Observed pediatric infection rates align with prior reports.
- Despite stable length of stay, healthcare costs for pediatric osteoarticular infections have risen over time.
Background:
Prior reports suggest that osteoarticular infections may be increasing over time.
Questions/Purposes:
We sought to determine if incidence rates, median in-hospital costs, and length of stay (LOS) of osteomyelitis, septic arthritis (SA), and combined infections have changed over time for pediatric patients, and how they compare to previously reported rates.
Methods:
The Kids' Inpatient Database (KID), a US national sample of pediatric hospital discharge records from 1997, 2000, 2003, 2006, 2009, and 2012, was used to determine yearly estimated counts of infections in children 20 years of age or younger. US census data was used to calculate yearly incidence rates. Trend tests using linear contrast analysis were used to compare estimated median LOS and inflation-adjusted median costs over time for each type of infection.
Results:
From 1997 through 2012, the incidence rate of osteomyelitis increased from 7.9 to 10.5 per 100,000, SA was unchanged from 5.3 to 5.2 per 100, and combined infections increased from 0.8 to 1.3 per 100,000. Median LOS from 1997 to 2012 showed no significant change for osteomyelitis (5.0 to 4.9 days), SA (4.4 to 4.1 days), or combined infections (6.5 to 6.8 days). Median in-hospital costs from 1997 to 2012 increased for osteomyelitis ($7735 to $11,823), SA ($5041 to $10,574), and combined infections ($12,691 to $16,260).
Conclusion:
In pediatric patients, the estimated incidence rate of SA appeared stable, while rates of osteomyelitis and combined infections increased. These estimated rates fall within previously reported ranges. Despite stable LOS, costs have increased over time.
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