Shorter hospitalization trends among children with sickle cell disease

Jean L. Raphael, Brigitta U. Mueller, Marc A. Kowalkowski, Suzette Olu Busola Oyeku

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Vaso-occlusive crises (VOC) contribute to frequent hospitalizations among children with sickle cell disease (SCD). The objective of this study was to determine whether length of stay (LOS) has decreased for VOC hospitalizations between 1997 and 2009. Procedure: We analyzed pediatric discharges (aged 0-18) with a primary or secondary diagnosis of SCD with crisis from the Kid's Inpatient Database (years 1997, 2003, and 2009), a nationally representative sample of pediatric hospital discharges. We conducted bivariate and multivariate, sample-weighted linear regression analyses to determine associations between independent variables (patient demographics, hospital characteristics, co-diagnoses, and procedures) and LOS. Results: Both the number (22,661-21,741) and proportion of VOC hospitalizations (0.34-0.29%) among all pediatric hospitalizations marginally decreased between 1997 and 2009 (P<0.01). Mean LOS decreased from 4.59 to 4.21 days (P<0.01). For all study years, older age was the only socio-demographic variable associated with longer LOS, controlling for other factors. Between 1997 and 2009, LOS decreased for all age categories, with the largest statistically significant reduction occurring among adolescents (5.69-4.76 days). Conclusions: Nationally representative hospital data indicate modest but meaningful reductions in LOS for children with VOC over a 12-year period. Adolescents who typically have the greatest disease severity showed the largest reduction in LOS. However, adolescents continue to account for a large proportion of inpatient stays for VOC. These findings illustrate that the adolescent period is a critical time in the lifespan for targeted intervention. Pediatr Blood Cancer 2012;59:679-684.

Original languageEnglish (US)
Pages (from-to)679-684
Number of pages6
JournalPediatric Blood and Cancer
Volume59
Issue number4
DOIs
StatePublished - Oct 2012

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Sickle Cell Anemia
Length of Stay
Hospitalization
Inpatients
Demography
Pediatrics
Pediatric Hospitals
Linear Models
Regression Analysis
Databases
Neoplasms

Keywords

  • Health care utilization
  • Sickle cell disease

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Shorter hospitalization trends among children with sickle cell disease. / Raphael, Jean L.; Mueller, Brigitta U.; Kowalkowski, Marc A.; Oyeku, Suzette Olu Busola.

In: Pediatric Blood and Cancer, Vol. 59, No. 4, 10.2012, p. 679-684.

Research output: Contribution to journalArticle

Raphael, Jean L. ; Mueller, Brigitta U. ; Kowalkowski, Marc A. ; Oyeku, Suzette Olu Busola. / Shorter hospitalization trends among children with sickle cell disease. In: Pediatric Blood and Cancer. 2012 ; Vol. 59, No. 4. pp. 679-684.
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