Abu-Rmaileh Muhammad, Hairston Hayden C, Zaniletti Isabella, Kompelli Anvesh, Davis Kyle P, Gardner James Reed, Bolin Elijah H, Richter Gresham T
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Children's Hospital Association, Biostatistician, Lenexa, KS, USA.
Int J Pediatr. 2022 Sep 9;2022:4423558. doi: 10.1155/2022/4423558. eCollection 2022.
To examine admission trends, complications, and costs for inpatient infantile hemangioma (IH) associated with propranolol therapy utilizing the Pediatric Health Information System (PHIS) database. . A retrospective cohort study was completed using the PHIS database. The PHIS database was queried from 2008 to 2020 for children without cardiac disease and between the ages of three weeks and one year who were admitted with a diagnosis of IH and administered propranolol. Admissions were trended annually and by geographic region. Primary outcomes were length of stay (LOS), readmission, mortality, propranolol-related complications, and costs. Bivariate and multivariable analyses were employed to identify predictors of the primary outcomes.
A total of 2290 unique patient encounters were identified. Admissions steadily decreased after 2011, with variations by geographic region. There was no mortality and only 60 (2.6%) propranolol-related complications. African-American race (odds ratio (OR) 1.20 [95% CI: 1.02-1.41]), respiratory comorbidities (OR 2.04 [95% CI: 1.42-2.93]), neurologic conditions (OR 1.34 [95% CI: 1.09-1.59]), admission to an intensive care unit (OR 1.31 [95% CI: 1.09-1.59]), bronchospasm (OR 1.37 [95% CI: 1.22-1.55]), and hyperkalemia (OR 1.86 [95% CI: 1.08-3.20]) were associated with increased LOS. Neurologic conditions (OR 2.87 [95% CI: 1.76-4.67]) and respiratory comorbidities (OR 2.48 [CI: 1.43-4.30]) were associated with readmission. Average cost per admission was $5,158 ($3,259 to $8,560 range).
There is an overall national decline in rate of admissions for IH propranolol therapy. Inpatient admission may be beneficial for patients with neurologic or respiratory conditions.
利用儿科健康信息系统（PHIS）数据库，研究接受普萘洛尔治疗的住院婴儿血管瘤（IH）的入院趋势、并发症及费用。采用PHIS数据库完成一项回顾性队列研究。查询2008年至2020年PHIS数据库中无心脏病、年龄在3周龄至1岁之间、因IH诊断入院并接受普萘洛尔治疗的儿童。按年份和地理区域分析入院情况。主要结局指标为住院时长（LOS）、再入院率、死亡率、普萘洛尔相关并发症及费用。采用双变量和多变量分析确定主要结局指标的预测因素。
共识别出2290例独特的患者就诊案例。2011年后入院人数稳步下降，且存在地理区域差异。无死亡病例，仅60例（2.6%）出现普萘洛尔相关并发症。非裔美国人种族（比值比（OR）1.20 [95%置信区间：1.02 - 1.41]）、呼吸系统合并症（OR 2.04 [95%置信区间：1.42 - 2.93]）、神经系统疾病（OR 1.34 [95%置信区间：1.09 - 1.59]）、入住重症监护病房（OR 1.31 [95%置信区间：1.09 - 1.59]）、支气管痉挛（OR 1.37 [95%置信区间：1.22 - 1.55]）和高钾血症（OR 1.86 [95%置信区间：1.08 - 3.20]）与住院时长增加相关。神经系统疾病（OR 2.87 [95%置信区间：1.76 - 4.67]）和呼吸系统合并症（OR 2.48 [置信区间：1.43 - 4.30]）与再入院相关。每次入院的平均费用为5158美元（范围为3259美元至8560美元）。
全国范围内接受普萘洛尔治疗的IH入院率总体呈下降趋势。对于患有神经系统或呼吸系统疾病的患者，住院治疗可能有益。
