Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo-obstruction

Neurogastroenterol Motil. 2020 Apr;32(4):e13781. doi: 10.1111/nmo.13781. Epub 2019 Dec 29.

Abstract

Background: Pediatric intestinal pseudo-obstruction is a rare disorder affecting gastrointestinal motility leading to chronic symptoms and hospitalizations. There is limited understanding of the epidemiology and healthcare burden.

Methods: We analyzed data from Kids' Inpatient Database from 2016, which includes inpatient discharge records from US hospitals. ICD-10 codes were used to identify patients 0-18 years with pediatric intestinal pseudo-obstruction and comorbid conditions. Multivariable logistic regression and Wilcoxon rank-sum test were used.

Results: In 2016, there were 1671 inpatient discharges from US hospitals for patients 0-18 years of age with this diagnosis. The incidence of inpatient admission was 29/100 000 patients. After controlling for age, race, income status, and insurance, males vs females (adjusted odds ratio, aOR: 1.10; 95% CI: 0.94-1.28; P = .241) and caucasians vs other races (aOR: 1.55; 95% CI: 1.27-1.88; P < .001) were more likely to be admitted. Inpatient admissions incurred significant healthcare burden; median (inter quartile range IQR) cost of hospitalization of US$ 52 079 (US$ 23 530-120 961) and a median (IQR) length of stay of 6 days (3-14 days). Gastrostomy (32%) and ileostomy (12.6%) status appeared to incur lower healthcare burden. Parenteral nutrition, malnutrition, and central line/bloodstream infections resulted in higher healthcare burden.

Conclusions: Pediatric intestinal pseudo-obstruction is a rare diagnosis with a high incidence of inpatient admissions and healthcare burden. An aggressive multidisciplinary management is crucial in reducing inpatient admissions in this cohort.

Keywords: healthcare burden; inpatient admissions; motility; pediatric; pediatric gastroenterology; pseudo-obstruction.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cost of Illness*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Inpatients / statistics & numerical data*
  • Intestinal Pseudo-Obstruction / epidemiology*
  • Male
  • United States / epidemiology