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Epidemiology and Resource Utilization of Simple Febrile Seizure-associated Hospitalizations in the United States, 2003-2012

Huang, Yolanda Y., MD, PhD; Li, Guohua, MD, DrPH; Sun, Lena S., MD

Journal of Neurosurgical Anesthesiology: January 2019 - Volume 31 - Issue 1 - p 144–150
doi: 10.1097/ANA.0000000000000546
Supplement: Proceedings of the Sixth PANDA Symposium on “Anesthesia and Neurodevelopment in Children

Background: Simple febrile seizure (SFS) affects 2% to 4% of children under 6 years of age. The purpose of this study is to examine the epidemiologic patterns and resource utilization of SFS-associated hospitalizations in children aged younger than 6 years of age in the United States.

Materials and Methods: This study is a serial, retrospective analysis of the Healthcare Cost and Utilization Project Kids’ Inpatient Databases for the years 2003, 2006, 2009, and 2012. SFS-associated hospitalizations were identified based on International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis code 780.31. We calculated the proportion of hospitalizations in pediatric patients under 6 years of age due to SFS and all other nonbirth causes, the rate of SFS-associated hospitalizations per 100,000 population, the mean length of stay and inflation-adjusted hospital costs of SFS-associated hospitalizations, as well as patient demographics and hospital characteristics.

Results: From 2003 to 2012, the weighted proportion of hospitalizations due to SFS declined from 0.83% to 0.41% (P<0.01) and the annual rate of SFS-associated hospitalizations per 100,000 population decreased from 48.0 to 18.7 (P<0.01). However, use of computed tomography, electroencephalogram, and lumbar puncture in SFS-associated hospitalizations decreased significantly (all P<0.001), but the utilization rate of magnetic resonance imaging remained stable (P=0.53). The mean length of stay for SFS-associated hospitalizations decreased from 2.03 days in 2003 to 1.74 days in 2012, and the mean hospital costs (exclusive of professional payment) decreased from $3830 in 2003 to $3223 in 2012 (both P<0.001).

Conclusions: SFS-associated hospitalizations and resource utilization in children under 6 years of age have decreased markedly in the United States, probably due to improved clinical adherence to the practice parameters set forth by the American Academy of Pediatrics for managing patients with SFS.

Department of Anesthesiology, Columbia University, New York, NY

The authors have no funding or conflicts of interest to disclose.

Address correspondence to: Yolanda Y. Huang, MD, PhD, Columbia University College of Physician and Surgeons, 622 West, 168th Street, PH 544, New York, NY 10032 (e-mail:

Received September 5, 2018

Accepted September 9, 2018

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