美国 2003-2012 年单纯性热性惊厥相关住院的流行病学和资源利用情况。

Epidemiology and Resource Utilization of Simple Febrile Seizure-associated Hospitalizations in the United States, 2003-2012.

机构信息

Department of Anesthesiology, Columbia University, New York, NY.

出版信息

J Neurosurg Anesthesiol. 2019 Jan;31(1):144-150. doi: 10.1097/ANA.0000000000000546.

DOI:10.1097/ANA.0000000000000546

PMID:30767940

Abstract

BACKGROUND

Simple febrile seizure (SFS) affects 2% to 4% of children under 6 years of age. The purpose of this study is to examine the epidemiologic patterns and resource utilization of SFS-associated hospitalizations in children aged younger than 6 years of age in the United States.

MATERIALS AND METHODS

This study is a serial, retrospective analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Databases for the years 2003, 2006, 2009, and 2012. SFS-associated hospitalizations were identified based on International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis code 780.31. We calculated the proportion of hospitalizations in pediatric patients under 6 years of age due to SFS and all other nonbirth causes, the rate of SFS-associated hospitalizations per 100,000 population, the mean length of stay and inflation-adjusted hospital costs of SFS-associated hospitalizations, as well as patient demographics and hospital characteristics.

RESULTS

From 2003 to 2012, the weighted proportion of hospitalizations due to SFS declined from 0.83% to 0.41% (P<0.01) and the annual rate of SFS-associated hospitalizations per 100,000 population decreased from 48.0 to 18.7 (P<0.01). However, use of computed tomography, electroencephalogram, and lumbar puncture in SFS-associated hospitalizations decreased significantly (all P<0.001), but the utilization rate of magnetic resonance imaging remained stable (P=0.53). The mean length of stay for SFS-associated hospitalizations decreased from 2.03 days in 2003 to 1.74 days in 2012, and the mean hospital costs (exclusive of professional payment) decreased from $3830 in 2003 to $3223 in 2012 (both P<0.001).

CONCLUSIONS

SFS-associated hospitalizations and resource utilization in children under 6 years of age have decreased markedly in the United States, probably due to improved clinical adherence to the practice parameters set forth by the American Academy of Pediatrics for managing patients with SFS.

摘要

背景

单纯性热性惊厥 (SFS) 影响 6 岁以下儿童的 2%至 4%。本研究旨在研究美国 6 岁以下儿童 SFS 相关住院的流行病学模式和资源利用情况。

材料和方法

本研究是对 2003 年、2006 年、2009 年和 2012 年医疗保健成本和利用项目儿童住院数据库进行的一系列回顾性分析。基于国际疾病分类，第九版临床修订版，诊断代码 780.31，确定 SFS 相关住院的病例。我们计算了因 SFS 和所有其他非分娩原因导致的 6 岁以下儿科患者住院的比例、每 10 万人中 SFS 相关住院的发生率、每 10 万人中 SFS 相关住院的平均住院时间和通胀调整后的住院费用，以及患者人口统计学和医院特征。

结果

从 2003 年到 2012 年，因 SFS 导致的住院比例从 0.83%下降到 0.41%（P<0.01），每 10 万人中 SFS 相关住院的年发生率从 48.0 下降到 18.7（P<0.01）。然而，SFS 相关住院中 CT、脑电图和腰椎穿刺的使用率显著下降（均 P<0.001），但磁共振成像的使用率保持稳定（P=0.53）。SFS 相关住院的平均住院时间从 2003 年的 2.03 天下降到 2012 年的 1.74 天，平均住院费用（不包括专业支付）从 2003 年的 3830 美元下降到 2012 年的 3223 美元（均 P<0.001）。