Congenital anomalies and resource utilization in neonates infected with herpes simplex virus.

BACKGROUND

Neonatal herpes simplex virus (HSV) infection, while uncommon, is associated with substantial morbidity and mortality. However, there is little nationally representative data describing resource utilization.

METHODS

This retrospective cohort study was conducted using the Pediatric Health Information System, an administrative database that contains discharge diagnosis and resource utilization data from 35 free-standing children's hospitals. Patients <or=60 days of age with a primary discharge diagnosis of HSV were study eligible if they received intravenous acyclovir and were discharged between January 1, 2003 and December 31, 2005.

RESULTS

There were 406 patients with HSV. The median age was 16 days (interquartile range: 8-31 days); 52% of patients were female. Congenital heart disease, the most common congenital anomaly, occurred in 10% of patients. The median length of stay was 15 days; 21 (5%) patients died. HSV was associated with substantial resource utilization. The median hospital charge was $37,431 (interquartile range: $14,667-$74,559) per infant. The presence of congenital heart disease independently increased the hospital length of stay by 93% (adjusted LOS ratio: 1.93; 95% CI: 1.5-2.5).

CONCLUSIONS

HSV infection in neonates and young infants was associated with substantial resource utilization. The presence of an underlying congenital cardiac anomaly was associated with a significantly longer length of stay and higher hospital charges.