National Trends in Inpatient Hospital Outcomes of Children with Osteogenesis Imperfecta and the Importance of
Colby Nielsen1, R Reichenbach1, Dallin Merrell1
1University of Arizona College of Medicine, Phoenix, AZ.
Insights
Osteogenesis imperfecta (OI) is frequently linked to extraskeletal issues, particularly respiratory problems, impacting inpatient outcomes. This study highlights significant financial burdens and care disparities for OI patients.
Area of Science:
- Pediatric Health
- Genetic Disorders
- Healthcare Management
Background:
- Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility.
- Extraskeletal manifestations and their impact on inpatient outcomes in OI are not fully understood.
Purpose of the Study:
- To investigate the prevalence of extraskeletal manifestations in children with OI.
- To analyze inpatient outcomes, complications, and associated healthcare costs for OI patients.
Main Methods:
- Utilized the Kids' Inpatient Database (1997-2016) for a cross-sectional analysis.
- Collected and analyzed data on hospital characteristics, treatment costs, outcomes, and procedures for OI admissions.
Main Results:
- Over one-third of OI admissions involved extraskeletal manifestations.
- Minor complications (predominantly respiratory) occurred in 19.4% of cases; major complications in 3.85%.
- Neonatal mortality was 18.2%, while overall mortality was 1.0%; hospital charges increased over time.
Conclusions:
- Extraskeletal manifestations are common in OI, with respiratory complications being predominant.
- OI patients face significant financial burdens, risks of financial crisis, and healthcare disparities.
- Findings provide a comprehensive understanding of OI diagnosis, management, and associated challenges.
Objective:
To investigate the extent of extraskeletal manifestations along with inpatient outcomes and complications associated with osteogenesis imperfecta (OI).
Study Design:
This cross-sectional study utilized the Kids' Inpatient Database as a part of the Healthcare Cost and Utilization Project to investigate inpatient hospital outcomes and management in patients with OI from 1997 through 2016. Data regarding hospital characteristics, cost of treatment, inpatient outcomes, and procedures were collected and analyzed.
Results:
There were 7291 admissions that listed OI as a diagnosis in the Kids' Inpatient Database from 1997 through 2016. Unexpectedly, more than one-third of all admissions in these children with OI presented with an extraskeletal manifestation. The rate of major complications was 3.85%. The rate of minor complications was 19.4%, most commonly respiratory problems. The mortality rate was 18.2% in the neonatal period and 1.0% in all other admissions. Total charges of hospital stay increased over the years.
Conclusions:
We identified a striking prevalence of extraskeletal manifestations in OI along with inpatient outcomes and complications associated with OI, of which respiratory complications were predominant. We observed a significant financial burden for patients with OI and identified additional risks for financial crisis, in addition to disparities in care identified among socioeconomic groups. These data contribute to a more holistic understanding of OI from diagnosis to management.
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