Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
JAMA Otolaryngol Head Neck Surg. 2013 Feb;139(2):124-8. doi: 10.1001/jamaoto.2013.1234.
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.
Retrospective review using a pediatric national data set (Kids' Inpatient Database 2009).
Inclusion criteria were admissions with International Classification of Diseases, Ninth Revision, Clinical Modification, codes for both MRSA and specific neck and pharyngeal infections.
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.
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.
利用全国性数据库研究宫颈耐甲氧西林金黄色葡萄球菌（MRSA）感染，旨在提供规范数据并确定资源利用的变化。
使用儿科全国性数据（2009 年儿童住院数据库）进行回顾性审查。
纳入标准为国际疾病分类第 9 版临床修订版编码为 MRSA 和特定颈部和咽部感染的住院患者。
共 26829 例 MRSA 住院患者，其中 3571 例包括头颈部感染。入院时的平均（SE）年龄为 7.72（0.20）岁。大多数患者（65.0%）处于较低的前 2 个社会经济四分位数；最常见的付款人是医疗补助（53.3%）。每次住院的平均总费用为 20442 美元。平均（SE）住院时间（LOS）为 4.39（0.15）天；年龄（P <.001）和种族（P <.001）组之间存在显著差异。共有 1671 名儿童至少接受过 1 次手术引流术；在种族（P <.001）、年龄（P <.001）和社会经济（P =.048）组之间存在统计学差异。当比较 LOS、手术次数和总住院费用时，资源利用没有地域差异。
全国范围内，宫颈 MRSA 感染具有较大的社会经济影响。不同种族之间的资源利用存在差异。年龄较小的儿童住院时间较长，更有可能需要手术，需要更多的插管。来自最低社会经济群体的儿童更频繁地需要手术，但与其他 3 个群体相比，他们的 LOS 没有统计学差异。了解儿童宫颈 MRSA 感染的这些特征可以促进针对受影响人群的临床干预措施，以改善其护理。
