Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Texas Children's Hospital, Houston, Texas, USA.
Neurogastroenterol Motil. 2022 Jul;34(7):e14288. doi: 10.1111/nmo.14288. Epub 2021 Nov 19.
The healthcare burden of pediatric functional gastrointestinal pain disorders (FGIDs) is unclear. Our study aimed to characterize the burden of these hospitalizations in the United States (US).
We utilized the US National Inpatient Sample from 2002 to 2018 to capture pediatric hospitalizations (ages 4 to 18 years old) with a primary discharge diagnosis of abdominal pain, constipation, irritable bowel syndrome, dyspepsia, abdominal migraine, cyclic vomiting syndrome, or fecal incontinence. We calculated the FGID hospitalization prevalence rate, length of stay (LOS), and inflation-adjusted costs annually and assessed for statistically significant trend changes using joinpoint analyses.
22.3 million pediatric hospitalizations were captured, and 1 in 64 pediatric hospitalizations were attributed to a primary FGID hospitalization. The overall FGID hospitalization prevalence rate initially remained stable but decreased significantly from 2013 to 2018. Constipation and abdominal pain hospitalization rates, respectively, increased and decreased significantly over time. Constipation hospitalizations were more prevalent for younger non-Hispanic Blacks and Hispanics. FGID hospitalization rates stratified by sex were similar. Mean LOS was 2.3 days; average LOS increased significantly from 2002 to 2013 and then stabilized. FGID hospitalization costs averaged $6,216 per admission and increased significantly for all FGIDs except dyspepsia. Endoscopic procedures were the most common interventions.
CONCLUSIONS & INFERENCES: FGID hospitalization prevalence rates decreased recently, possibly due to national healthcare policy implementation. Nonetheless, constipation admissions increased. LOS was stable in recent years but associated costs-per-hospitalization were increasing over time, probably due to endoscopic procedures. More studies are needed to explain these prevalence and cost trends.
儿科功能性胃肠疼痛障碍（FGIDs）的医疗负担尚不清楚。我们的研究旨在描述美国（US）这些住院治疗的负担。
我们利用美国国家住院患者样本（2002 年至 2018 年），对主要诊断为腹痛、便秘、肠易激综合征、消化不良、腹型偏头痛、周期性呕吐综合征或大便失禁的儿科住院患者进行了捕获。我们每年计算 FGID 住院治疗的患病率、住院时间（LOS）和通货膨胀调整后的费用，并使用连接点分析评估是否存在统计学上的显著趋势变化。
共捕获了 2230 万例儿科住院患者，每 64 例儿科住院患者中就有 1 例归因于原发性 FGID 住院患者。总体 FGID 住院治疗的患病率最初保持稳定，但从 2013 年到 2018 年显著下降。便秘和腹痛的住院率分别呈显著增加和减少的趋势。非西班牙裔黑人与西班牙裔的年轻患者中，便秘住院的比例较高。按性别分层的 FGID 住院率相似。平均 LOS 为 2.3 天；平均 LOS 从 2002 年到 2013 年显著增加，然后稳定下来。FGID 住院治疗的费用平均为每次入院 6216 美元，除消化不良外，所有 FGIDs 的费用都显著增加。内镜检查是最常见的干预措施。
FGID 住院治疗的患病率最近有所下降，可能是由于国家医疗保健政策的实施。尽管如此，便秘入院人数仍在增加。近年来 LOS 保持稳定，但与每次住院相关的费用却在不断增加，这可能是由于内镜检查。需要进一步研究来解释这些流行率和成本趋势。
