Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS.
Department of Data Science, University of Mississippi Medical Center, Jackson, MS.
J Pediatr. 2018 Aug;199:118-123.e1. doi: 10.1016/j.jpeds.2018.03.036. Epub 2018 Apr 26.
To assess risk factors, geographic distribution, length of stay, and total charges per case of symptomatic congenital cytomegalovirus infection (cCMV).
We performed retrospective analyses of serial cross-sectional data using the Kids' Inpatient Database, a nationally representative sample of US pediatric hospital discharges, from 2000, 2003, 2006, 2009, and 2012. Symptomatic cCMV was identified via use of the International Classification of Diseases, Ninth Revision, Clinical Modification code 771.1 among records with in-hospital birth that were accompanied by 1 or more characteristic symptoms. Demographic characteristics were compared with multivariable logistic regression. Temporal trend was assessed using linear regression. Charges were adjusted for inflation to 2012 US dollars.
We identified 1349 cases of symptomatic cCMV (SE 56). Symptomatic cCMV was associated with non-Hispanic black race (OR 1.70; 95% CI 1.37-2.10), government-sponsored insurance (OR 1.95; 95% CI 1.34-2.83), and birth in the American South and West (OR 1.68, 95% CI 1.35-2.09 and OR 1.61, 95% CI 1.23-2.09, respectively). In-hospital mortality and preterm birth rate ranged from 3.2%-6.8% and 50.4%-59.2%, respectively, without temporal changes. The geometric mean of total charges per case doubled from $45 771 (SE $8509) in 2000 to $89 846 (SE $10 358) in 2006 (P = .002) but did not change from 2006 to 2012. Length of stay in days was 15 (IQR 8-22) in 2000, 27 (IQR, 9-51) in 2009, and 18 (IQR, 8-47) in 2012.
Symptomatic cCMV was associated with non-Hispanic black race, low socioeconomic status, and birth in the American South and West and resulted in substantial healthcare burden.
评估有症状先天性巨细胞病毒感染（cCMV）的风险因素、地理分布、住院时间和每个病例的总费用。
我们使用 Kids' Inpatient Database（美国儿科住院患者的全国代表性样本）进行了回顾性分析，该数据库是一个时间序列的横截面数据集，数据来源于 2000 年、2003 年、2006 年、2009 年和 2012 年。通过使用住院分娩记录中的国际疾病分类，第九版临床修订版代码 771.1 来识别有症状的 cCMV，这些记录伴有 1 种或多种特征性症状。使用多变量逻辑回归比较人口统计学特征。使用线性回归评估时间趋势。根据 2012 年的美国美元进行费用调整。
我们确定了 1349 例有症状的 cCMV（SE 56）。有症状的 cCMV 与非西班牙裔黑人种族（OR 1.70；95%CI 1.37-2.10）、政府赞助的保险（OR 1.95；95%CI 1.34-2.83）以及在美国南部和西部出生（OR 1.68，95%CI 1.35-2.09 和 OR 1.61，95%CI 1.23-2.09）相关。住院死亡率和早产率分别为 3.2%-6.8%和 50.4%-59.2%，无时间变化。每个病例的总费用的几何平均值从 2000 年的 45771 美元（SE 8509 美元）增加到 2006 年的 89846 美元（SE 10358 美元）（P=0.002），但从 2006 年到 2012 年没有变化。住院天数在 2000 年为 15（IQR 8-22），在 2009 年为 27（IQR 9-51），在 2012 年为 18（IQR 8-47）。
有症状的 cCMV 与非西班牙裔黑人种族、低社会经济地位以及在美国南部和西部出生有关，并且给医疗保健带来了巨大的负担。
