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American Academy of Pediatrics
Article

Trends in Hospitalization for Pediatric Pulmonary Hypertension

Bryan G. Maxwell, Melanie K. Nies, Chinwe C. Ajuba-Iwuji, John D. Coulson and Lewis H. Romer
Pediatrics July 2015, peds.2014-3834; DOI: https://doi.org/10.1542/peds.2014-3834
Bryan G. Maxwell
Departments of aAnesthesiology and Critical Care Medicine,
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Melanie K. Nies
bPediatrics,
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Chinwe C. Ajuba-Iwuji
Departments of aAnesthesiology and Critical Care Medicine,
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John D. Coulson
bPediatrics,
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Lewis H. Romer
Departments of aAnesthesiology and Critical Care Medicine,
bPediatrics,
cBiomedical Engineering, and
dCell Biology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Abstract

BACKGROUND AND OBJECTIVES: Pulmonary hypertension (PH) has been associated with substantial morbidity and mortality in children, but existing analyses of inpatient care are limited to small single-institution series or focused registries representative of selected patient subgroups. We examined US national data on pediatric PH hospitalizations to determine trends in volume, demographics, procedures performed during admission, and resource utilization.

METHODS: Retrospective cohort study using a national administrative database of pediatric hospital discharges: the Kids’ Inpatient Database.

RESULTS: Children with PH accounted for 0.13% of the 43 million pediatric hospitalizations in the United States between 1997 and 2012, and discharges demonstrated an increasing trend over the study period (P < .0001). Cumulative, inflation-adjusted national hospital charges for PH hospitalizations rose (P = .0003) from $926 million in 1997 to $3.12 billion in 2012. Patients with PH without associated congenital heart disease (CHD) comprised an increasing and majority (56.4%) proportion over the study period (P < .0001), children without associated CHD admitted at urban teaching hospitals comprised the fastest-growing subgroup. In-hospital, all-cause mortality was high (5.9%) in children with PH, but demonstrated a decreasing trend (P < .0001).

CONCLUSIONS: Morbidity and mortality of pediatric PH continue to represent substantial and growing health care burdens. Shifts in case mix toward PH not associated with CHD, toward noncardiac procedures, and toward care in urban teaching hospitals will increase pressure to manage resource utilization in this small but growing patient group and to improve expertise and define excellence in PH care across a wide range of clinical settings.

  • Accepted May 13, 2015.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 147, Issue 4
1 Apr 2021
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Trends in Hospitalization for Pediatric Pulmonary Hypertension
Bryan G. Maxwell, Melanie K. Nies, Chinwe C. Ajuba-Iwuji, John D. Coulson, Lewis H. Romer
Pediatrics Jul 2015, peds.2014-3834; DOI: 10.1542/peds.2014-3834

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Trends in Hospitalization for Pediatric Pulmonary Hypertension
Bryan G. Maxwell, Melanie K. Nies, Chinwe C. Ajuba-Iwuji, John D. Coulson, Lewis H. Romer
Pediatrics Jul 2015, peds.2014-3834; DOI: 10.1542/peds.2014-3834
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