Treatment trends and outcomes in US hospital stays of children with empyema

The Pediatric Infectious Disease Journal
Michelle M KellyM Bruce Edmonson

Abstract

Recently published practice guidelines continue to reflect uncertainty about the comparative effectiveness of various treatments for empyema in children. We describe treatment trends and outcomes in pediatric empyema using the most current nationally representative data. Using survey methods and Kids' Inpatient Databases from 1997 to 2009, we evaluated hospital stays in children 0-18 years of age. We used 2009 data to compare transfer-out rates and lengths of stay across various types of treatment, after adjusting for patient and hospital factors. From 1997 to 2009, empyema discharges steadily increased from 3.1 to 6.0 per 100,000 children (P < 0.001 for trend) and also were increasingly likely (P < 0.01) to be coded for: (1) at least 1 pleural drainage procedure (76.4-83.2%), (2) multiple drainage procedures (36.0-41.6%) and (3) home health care (8.7-15.0%). By 2009, video-assisted thoracoscopic surgery was more commonly coded than chest tube drainage and was associated with a lower transfer-out rate (0.6% vs. 10.1%, adjusted P < 0.001) but no reduction in mean length of stay [11.2 vs. 13.4 days, adjusted incidence rate ratio 0.95 (95% confidence interval: 0.88-1.04)] for children neither admitted nor discharged by transfer. U...Continue Reading

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Citations

Jul 8, 2015·The Clinical Respiratory Journal·Paulo CamargosChequer Chamone
Sep 21, 2016·Pediatric Pulmonology·Florian J SegererJohannes G Liese
Mar 13, 2018·Current Opinion in Pediatrics·Michael C Tracy, Roshni Mathew
May 5, 2017·Archives of Disease in Childhood·Christopher William CourseIolo Doull
Oct 2, 2020·Annals of the American Thoracic Society·Ishaan GuptaMajid Shafiq

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