From the Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA.
the Department of Medical Research & Education, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
J Pediatr Gastroenterol Nutr. 2023 Mar 1;76(3):385-389. doi: 10.1097/MPG.0000000000003694. Epub 2022 Dec 27.
This study examines the sociodemographic differences between elective and nonelective admissions for failure to thrive (FTT). We investigate associations between admission type and hospital resource utilization, including length of stay and feeding tube placement.
We included children <2 years old with FTT in the nationwide Kids' Inpatient Database. We described differences between elective and nonelective admissions using Fisher exact and t tests. To assess associations of admission type and hospital resource utilization, we used negative binomial and logistic regression for length of stay and feeding tube placement, respectively.
In this study of 45,920 admissions (37,224 nonelective vs 8696 elective), we found differences by race and ethnicity, income, and insurance type, among other factors. Compared to elective admissions, nonelective admissions had higher proportions of infants who were Black, Hispanic, and of lower-income. Nonelective admissions were associated with longer lengths of stay (incidence rate ratio 1.46; 95% CI: 1.37-1.55), independent of child age, sex, neighborhood income, insurance, admission day, chronic conditions, and location. Nonelective admissions were associated with lower odds of feeding tube placement compared to elective admissions (adjusted odds ratio 0.62; 0.56-0.68). In the stratified analyses, children of racial and ethnic minority groups admitted nonelectively versus electively had relatively higher odds of feeding tube placement, while White children had relatively lower odds of feeding tube placement.
There are various sociodemographic differences between elective and nonelective FTT admissions. Future research is warranted to elucidate drivers of these differences, particularly those related to racial and ethnic disparities and structural racism.
本研究考察了因生长迟缓（FTT）而择期和非择期入院的社会人口学差异。我们调查了入院类型与医院资源利用之间的关联，包括住院时间和置管喂养。
我们纳入了全国儿童住院数据库中<2 岁的 FTT 儿童。我们使用 Fisher 精确检验和 t 检验描述了择期和非择期入院之间的差异。为了评估入院类型与医院资源利用之间的关联，我们分别使用负二项回归和逻辑回归分析住院时间和置管喂养。
在这项研究中，我们纳入了 45920 例入院（37224 例非择期 vs 8696 例择期），发现了种族和民族、收入和保险类型等因素的差异。与择期入院相比，非择期入院的婴儿中黑人、西班牙裔和低收入者的比例更高。非择期入院与住院时间延长相关（发病率比 1.46；95%CI：1.37-1.55），与儿童年龄、性别、社区收入、保险、入院日、慢性疾病和位置无关。与择期入院相比，非择期入院与置管喂养的可能性较低相关（调整后的优势比 0.62；0.56-0.68）。在分层分析中，与择期入院相比，非择期入院的少数族裔儿童置管喂养的可能性相对较高，而白人儿童置管喂养的可能性相对较低。
择期和非择期 FTT 入院之间存在各种社会人口学差异。需要进一步研究阐明这些差异的驱动因素，特别是与种族和民族差异以及结构性种族主义相关的因素。
