Related Experiment Video
Updated: Dec 20, 2025
Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
Published on: March 31, 2023
Hospital Charges Associated with Central Venous Stenosis in Pediatric Patients Requiring Long-Term Central Venous
Alexander Dabrowiecki1, Nima Kokabi1, Hannah Hua2
1Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image Guided Medicine, Emory University, Atlanta, GA.
Insights
Central venous stenosis in pediatric patients significantly increases hospital charges and length of stay. Mitigating stenosis incidence is crucial for reducing healthcare costs and improving patient outcomes.
Area of Science:
- Pediatric Nephrology
- Pediatric Gastroenterology
- Vascular Access Management
Background:
- Central venous catheters are vital for pediatric patients with short bowel syndrome (SBS) and end-stage renal disease (ESRD).
- Central venous stenosis (CVS) is a potential complication impacting long-term catheter use.
- Understanding the economic burden of CVS in these vulnerable populations is essential.
Purpose of the Study:
- To evaluate hospital charges and length of stay (LOS) associated with central venous stenosis (CVS) in pediatric patients requiring long-term central venous catheters.
- To compare the healthcare resource utilization between pediatric patients with and without CVS.
Main Methods:
- Retrospective review of pediatric patients with SBS or ESRD and central venous catheters (2008-2015).
- Data collected included prevalence of CVS, admissions, procedures, LOS, and associated hospital charges.
- Statistical analysis using Wilcoxon nonparametric and 2-sample t tests (P < .05).
Main Results:
- 3.7% of patients (360 total) were diagnosed with CVS.
- Patients with CVS had significantly higher cumulative admissions and LOS for both SBS (15 admissions, 156 days) and ESRD (13 admissions, 72 days) cohorts compared to those without.
- Mean cumulative charges were substantially higher for patients with CVS: $1.89M (SBS) and $1.17M (ESRD) vs. $1.11M (SBS) and $702K (ESRD).
Conclusions:
- Pediatric patients with central venous stenosis experience significantly increased total hospital charges, imaging costs, admissions, and length of stay.
- These findings underscore the importance of strategies to prevent or mitigate central venous stenosis in pediatric patients reliant on long-term central venous access.
Objective:
To evaluate the hospital charges associated with central venous stenosis in pediatric patients requiring long-term central venous catheters, via associated charges and hospital length of stay (LOS).
Study Design:
This institutional review board-approved retrospective review identified pediatric patients with central venous catheters and either short bowel syndrome (SBS) or end-stage renal disease (ESRD) diagnosed between 2008 and 2015 using the Pediatric Health Information System. These 2 cohorts were selected because long-term central venous access is commonly required for survival. Prevalence of central venous stenosis, total number of admissions, procedures, LOS, and associated charges were recorded. Statistical analysis performed with Wilcoxon nonparametric and 2-sample t test with a significance of P < .05.
Results:
Of 4952 patients with SBS and 4665 patients with ESRD, 169 (3.4%) patients with SBS and 191 (4.1%) patients with ESRD were diagnosed with central venous stenosis (360 patients total [3.7%]). The cumulative median admissions and LOS was higher in patients with SBS with central venous stenosis (15 admissions and 156 days) vs those without central venous stenosis (5 admissions and 110 days) (P < .001). The cumulative median number of admissions and LOS was higher in patients with ESRD with central venous stenosis (13 admissions and 72 days) vs those without central venous stenosis (7 admissions and 42 days) (P < .001). The mean cumulative charges for patients with SBS with central venous stenosis were higher than for those without central venous stenosis ($1.89 million vs $1.11 million, respectively) (P < .001). Similarly, the mean cumulative charges for patients with ESRD with central venous stenosis were higher than for those without central venous stenosis ($1.17 millions vs $702 000, respectively) (P < .001).
Conclusions:
Pediatric patients with central venous stenosis have significantly higher total charges, imaging charges, number of admissions, and longer LOS. Attention to mitigate the incidence of central venous stenosis in pediatric patients requiring long-term central venous access is warranted.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:29Venous Thrombosis III: Interprofessional Care
01:24Hemodialysis II: Procedure and Complications
01:30Venous Thrombosis IV: Nursing Management
01:29Endocarditis IV: Nursing Management
01:22Aneurysm IV: Nursing Management