Faculty Collaboration Database

Socioeconomic implications of pediatric cervical methicillin-resistant Staphylococcus aureus infections. JAMA Otolaryngol Head Neck Surg 2013 Feb;139(2):124-8

Date

01/19/2013

Pubmed ID

23328944

DOI

10.1001/jamaoto.2013.1234

Scopus ID

2-s2.0-84875413466 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

OBJECTIVE: To study cervical methicillin-resistant Staphylococcus aureus (MRSA) infections using a national database with the goal of providing normative data and identifying variations in resource utilization.

DESIGN: Retrospective review using a pediatric national data set (Kids' Inpatient Database 2009).

SUBJECTS: Inclusion criteria were admissions with International Classification of Diseases, Ninth Revision, Clinical Modification, codes for both MRSA and specific neck and pharyngeal infections.

RESULTS: There were 26,829 admissions with MRSA; 3571 included a head and neck infection. The mean (SE) age at admission was 7.72 (0.20) years. Most patients (65.0%) were in the lower 2 socioeconomic quartiles; the most common payer was Medicaid (53.3%). The mean total charge per admission was $20,442. The mean (SE) length of stay (LOS) was 4.39 (0.15) days; there were significant differences among age (P < .001) and racial (P < .001) groups. A total of 1671 children underwent at least 1 surgical drainage procedure; there were statistically significant differences among racial (P < .001), age (P < .001), and socioeconomic (P = .048) groups. There were no regional variations in resource utilization when LOS, number of procedures, and total hospital charges were compared.

CONCLUSIONS: Cervical MRSA infections have a large socioeconomic impact across the nation. There are differences among the various races in resource utilization. Younger children have longer hospitalizations, are more likely to need surgery, and require more intubations. Children from the lowest socioeconomic group require surgery more frequently, but their LOS is not statistically different when compared with the other 3 groups. Knowledge of such characteristics for cervical MRSA infections in children can facilitate targeted clinical interventions to improve care of affected populations.

Author List

McCormick ME, Chun RH, Lander L, Shah RK

Authors

Robert H. Chun MD Professor in the Otolaryngology department at Medical College of Wisconsin
Michael E. McCormick MD Associate Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abscess
Age Factors
Cellulitis
Child
Child, Preschool
Databases, Factual
Drainage
Female
Hospital Charges
Humans
Income
Length of Stay
Male
Medicaid
Methicillin-Resistant Staphylococcus aureus
Regression Analysis
Retrospective Studies
Staphylococcal Infections
Stomatognathic Diseases
United States