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Hospitalization rates for pediatric osteoarticular infections rise
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Nationally representative data suggest a 15% increase in hospitalizations associated with pediatric osteoarticular infections occurred between 1997 and 2012, partially driven by MRSA infections, according to recent study results.
“We found evidence that MRSA-associated osteoarticular infections may be more complicated, with a longer hospital length of stay, a larger number of therapeutic procedures and higher charges,” Chris Stockmann, MSc, of the division of pediatric infectious diseases and the department of pediatrics at the University of Utah School of Medicine, and colleagues wrote.
In the retrospective cohort study, Stockmann and colleagues sought to assess the national incidence, outcomes and hospitalization costs associated with pediatric pyogenic arthritis and osteomyelitis. The same were assessed and compared between MRSA-coded osteoarticular infections vs. infections caused by other organisms.
As of 2012, data from 44 states were included in the U.S. Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project Kids’ Inpatient Database.
Study results suggested that the incidence for osteoarticular infections increased from 2.07 cases per 1,000 hospital admissions to 2.38 cases per 1,000 hospital admissions during 1997 and 2012, a 15% increase (95% CI, 12-19). Specifically, MRSA-coded infections increased from 0.02 cases per 1,000 hospital admissions to 0.36 cases per 1,000 hospital admissions during the period.
The increase in osteoarticular infections was driven by a 28% rise in osteomyelitis cases. The incidence for pyogenic arthritis also increased from 1.23 cases per 1,000 hospital admissions to 1.36 cases per 1,000 hospital admissions (P <.001).
Pediatric osteoarticular infections varied by age and region. For example, there was a 29% increase in the Midwest (P <.001) and a 27% increase in the South (P <.001), while incidence decreased by 12% in the West (P <.001).
Researchers observed a 94% increase in the amount of MRIs performed and an 18-hour increase in the median total hospital length of stay. Compared with a median inflation-adjusted hospital charge of $17,677 during 1997, the charge rose to $34,549 during 2012 (P <.001). Moreover, the yearly median increase in hospital charges for pyogenic arthritis was $643 and $1,270 for osteomyelitis.
Having a MRSA-coded infection was associated with longer lengths of hospital stay (median 7 days; P < .001) and higher costs (median $42,982; P <.001). Compared with 86% of children with a MRSA-code who underwent therapeutic procedures, 78% of children without a MRSA-code underwent therapeutic procedures (P < .001).
“MRSA-associated osteoarticular infections may be more severe than those caused by other organisms,” Stockmann and colleagues wrote. “Effective preventive and therapeutic strategies are needed to reduce the clinical and economic burden of pediatric osteoarticular infections.” – by Jennifer Southall
Disclosure: Stockmann reports receiving financial support from the American Foundation for Pharmaceutical Education’s Clinical Pharmaceutical Sciences Fellowship.
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