The aims of this study were to measure inpatient health care for pediatric hydrocephalus in the US; describe patient, hospital, and hospitalization characteristics for pediatric hydrocephalus inpatient care; and determine characteristics associated with death.
A cross-sectional study was performed using the 1997, 2000, and 2003 Healthcare Cost and Utilization Project Kids' Inpatient Databases (KID), nationally representative weighted data sets of hospital discharges for pediatric patients. A hydrocephalus-related hospitalization was classified as either cerebrospinal fluid (CSF) shunt–related (including initial placements, infections, malfunctions, or other) or non–CSF shunt–related. Patients > 18 years of age were excluded. The KID provided weighted estimates of 6.657, 6.597, and 6.732 million total discharges in the 3 study years.
Each year there were 38,200–39,900 admissions, 391,000–433,000 hospital days, and total hospital charges of $1.4–2.0 billion for pediatric hydrocephalus. Hydrocephalus accounted for 0.6% of all pediatric hospital admissions in the US in 2003, but for 1.8% of all pediatric hospital days and 3.1% of all pediatric hospital charges. Over the study years, children admitted with hydrocephalus were older, had an increase in comorbidities, and were admitted more frequently to teaching hospitals. Compared with children who survived, those who died were more likely to be < 3 months of age and have a birth-related admission, have no insurance, have comorbidities, be transferred, and have a non–CSF shunt–related admission.
Children with hydrocephalus have a chronic illness and use a disproportionate share of hospital days and healthcare dollars in the US. Since 1997 they have increased in age and in number of comorbid conditions. For important changes in morbidity and mortality rates to be made, focused research efforts and funding are necessary.
Abbreviations used in this paper:AOR = adjusted odds ratio; CI = confidence interval; CSF = cerebrospinal fluid; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; KID = Kids' Inpatient Databases; LOS = length of stay; NACHRI = National Association of Children's Hospitals and Related Institutions; NIH = National Institutes of Health; SD = standard deviation; VP = ventriculoperitoneal.
Address correspondence to: Tamara D. Simon, M.D., M.S.P.H., Primary Children's Medical Center, Division of Inpatient Medicine, 100 North Medical Drive, Salt Lake City, Utah 84113. email:
ChuBHouchensRElixhauserARossD: Using the KIDS' Inpatient Database (KID) to Estimate Trends. HCUP Methods Series Report # 2007–02Rockville, MDU.S. Agency for Healthcare Research and Quality2007. (http://www.hcup-us.ahrq.gov/reports/methods.jsp.) [Accessed 17 October 2007]
ChuB, HouchensR, ElixhauserA, RossD: Rockville, MD, U.S. Agency for Healthcare Research and Quality, 2007. (http://www.hcup-us.ahrq.gov/reports/methods.jsp.) [Accessed 17 October 2007])| false
National Center for Health Statistics: Conversion Table of New ICD-9-CM Codes October 2004Atlanta, GACenters for Disease Control2004. (http://www.cdc.gov/nchs/data/icd9/icdcnv05.pdf) [Accessed 15 November 2007]
National Center for Health Statistics: Atlanta, GA, Centers for Disease Control, 2004. (http://www.cdc.gov/nchs/data/icd9/icdcnv05.pdf) [Accessed 15 November 2007])| false
National Institute of Neurological Disorders and Stroke: Hydrocephalus: Myths New Facts Clear DirectionsBethesda, MDNINDS2005. (http://www.ninds.nih.gov/news_and_events/proceedings/Hydrocephalus_2005.htm) [Accessed 17 October 2007]
National Institute of Neurological Disorders and Stroke: Bethesda, MD, NINDS, 2005. (http://www.ninds.nih.gov/news_and_events/proceedings/Hydrocephalus_2005.htm) [Accessed 17 October 2007])| false
SmithERButlerWEBarkerFGII: In-hospital mortality rates after ventriculoperitoneal shunt procedures in the United States, 1998 to 2000: relation to hospital and surgeon volume of care. J Neurosurg100:2 Suppl Pediatrics90–972004
SmithER, ButlerWE, BarkerFGII: In-hospital mortality rates after ventriculoperitoneal shunt procedures in the United States, 1998 to 2000: relation to hospital and surgeon volume of care. 100:2 Suppl Pediatrics90–97, 2004)| false