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Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e31828aa71f
Neurocritical Care

Hospitalizations of Children With Neurologic Disorders in the United States

Moreau, Jacqueline F. BA1; Fink, Ericka L. MD1,2; Hartman, Mary E. MD, MPH3; Angus, Derek C. MD, MPH1; Bell, Michael J. MD2; Linde-Zwirble, Walter T.4; Watson, R. Scott MD, MPH1

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Abstract

Objectives: Although neurologic disorders are among the most serious acute pediatric illnesses, epidemiologic data are scarce. We sought to determine the scope and outcomes of children with these disorders in the United States.

Design: Retrospective cohort study.

Setting: All nonfederal hospitals in 11 states encompassing 38% of the U.S. pediatric population.

Patients: Children 29 days to 19 years old hospitalized in 2005.

Interventions: None.

Measurements and Main Results: Using International Classification of Diseases, 9th Revision, Clinical Modification, codes, we identified admissions with neurologic diagnoses, analyzed patient and hospitalization characteristics, and generated age- and sex-adjusted national estimates. Of 960,020 admissions in the 11 states, 10.7% (103,140) included a neurologic diagnosis, which yields a national estimate of 273,900 admissions of children with neurologic diagnoses. The most common were seizures (53.9%) and traumatic brain injury (17.3%). Children with neurologic diagnoses had nearly three times greater ICU use than other hospitalized children (30.6% vs 10.6%, p < 0.001). Neurologic diagnoses were associated with nearly half of deaths (46.2%, n = 1,790). Among ICU patients, children with neurologic diagnoses had more than three times the mortality of other patients (4.8% vs1.5%, p < 0.001). Children with neurologic diagnoses had a significantly longer median hospital length of stay than other children (3 d [1, 5] vs 2 d [2, 4], p < 0.001) and greater median hospital costs ($4,630 [$2,380, $9,730] vs $2,840 [$1,520, $5,550], p < 0.001).

Conclusions: Children with neurologic diagnoses account for a disproportionate amount of ICU stays and deaths compared with children hospitalized for other reasons.

©2013The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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