Hirsch Alexander W, Monuteaux Michael C, Fruchtman Genna, Bachur Richard G, Neuman Mark I
Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
Hosp Pediatr. 2016 Nov;6(11):659-666. doi: 10.1542/hpeds.2016-0064. Epub 2016 Oct 10.
Unlike community-acquired pneumonia (CAP), there is a paucity of data characterizing the patient demographics and hospitalization characteristics of children with aspiration pneumonia. We used a large national database of US children's hospitals to assess the patient and hospitalization characteristics associated with aspiration pneumonia and compared these characteristics to patients with CAP.
We identified children hospitalized with a diagnosis of aspiration pneumonia or CAP at 47 hospitals included in the Pediatric Health Information System between 2009 and 2014. We evaluated whether differences exist in patient characteristics (median age and proportion of patients with a complex chronic condition), and hospital characteristics (length of stay, ICU admission, cost, and 30-day readmission rate) between children with aspiration pneumonia and CAP. Lastly, we assessed whether seasonal variability exists within these 2 conditions.
Over the 6-year study period, there were 12 097 children hospitalized with aspiration pneumonia, and 121 489 with CAP. Compared with children with CAP, children with aspiration pneumonia were slightly younger and more likely to have an associated complex chronic condition. Those with aspiration pneumonia had longer hospitalizations, higher rates of ICU admission, and higher 30-day readmission rates. Additionally, the median cost for hospitalization was 2.4 times higher for children with aspiration pneumonia than for children with CAP. More seasonal variation was observed for CAP compared with aspiration pneumonia hospitalizations.
Aspiration pneumonia preferentially affects children with medical complexity and, as such, accounts for longer and more costly hospitalizations and higher rates of ICU admission and readmission rates.
与社区获得性肺炎(CAP)不同,关于误吸性肺炎患儿的人口统计学特征和住院特征的数据较少。我们使用了一个大型的美国儿童医院全国数据库,以评估与误吸性肺炎相关的患者和住院特征,并将这些特征与CAP患者进行比较。
我们确定了2009年至2014年期间在儿科健康信息系统中的47家医院住院并诊断为误吸性肺炎或CAP的儿童。我们评估了误吸性肺炎患儿和CAP患儿在患者特征(中位年龄和患有复杂慢性病的患者比例)以及医院特征(住院时间、入住ICU、费用和30天再入院率)方面是否存在差异。最后,我们评估了这两种情况是否存在季节性变化。
在6年的研究期间,有12097名儿童因误吸性肺炎住院,121489名儿童因CAP住院。与CAP患儿相比,误吸性肺炎患儿年龄稍小,更有可能患有相关的复杂慢性病。那些患有误吸性肺炎的患儿住院时间更长,入住ICU的比例更高,30天再入院率也更高。此外,误吸性肺炎患儿的住院中位费用比CAP患儿高出2.4倍。与误吸性肺炎住院相比,CAP的季节性变化更为明显。
误吸性肺炎优先影响患有复杂疾病的儿童,因此导致住院时间更长、费用更高,入住ICU的比例和再入院率也更高。