Changes in hospital utilization and management of Hirschsprung disease

Analysis using the kids' inpatient database

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVE: This study investigates how the epidemiology, hospital utilization, and surgical management of Hirschsprung disease (HD) have changed over the last decade in the United States, using a statistically valid national sample. BACKGROUND: HD is a congenital gastrointestinal disorder that requires surgical resection for correction. Some patients experience long-term bowel dysfunction requiring hospital care. Historically, patients had multiple staged operations, whereas more recently, single-stage laparoscopic resection and pull-through operations are more common. Assessment of possible changes over time in HD-associated complications requiring hospitalization and length of hospital stay has not been quantified epidemiologically. METHODS: The Kids' Inpatient Database was queried for all discharges with an International Classification of Disease, Ninth Revision, Clinical Modification code for HD in the years 1997, 2000, 2003, and 2006. The HD cohorts from these 4 time points were compared, specifically analyzing differences in demographic data, associated diagnoses, in-hospital mortality and length of stay, procedures performed during hospitalization, and frequency of hospitalizations for HD-associated complications. Results reported included estimated frequencies and means with 95% confidence intervals. RESULTS: The estimated numbers of HD discharges, associated demographic data, and numbers of pull-through procedures have remained stable over the decade. The mean age (years) at the time of pull-through has decreased from 1.45 to 1.16 to 1.18 to 0.97 (P = 0.01). The mean length of stay (days) for these procedures has increased from 8.40 to 8.46 to 9.25 to 10.55 (P = 0.002). The estimated numbers of hospital admissions for HD-related constipation increased in recent years from 395 to 340 to 536 to 566 (P = 0.001). The estimated numbers of admissions for enterocolitis suggest an increasing trend from 466 to 402 to 584 to 556 (P = 0.11). CONCLUSIONS: HD pull-through procedures are being performed at younger ages over time, and post-pull-through lengths of stay have increased. Admissions for some HD-related complications have increased over the decade. Prospective cohort studies are needed to determine whether causal relationships exist among these trends.

Original languageEnglish (US)
Pages (from-to)371-375
Number of pages5
JournalAnnals of surgery
Volume257
Issue number2
DOIs
StatePublished - Feb 1 2013

Fingerprint

Hirschsprung Disease
Inpatients
Databases
Length of Stay
Hospitalization
Demography
Enterocolitis
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
International Classification of Diseases
Constipation
Hospital Mortality
Epidemiology
Cohort Studies
Prospective Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Changes in hospital utilization and management of Hirschsprung disease : Analysis using the kids' inpatient database. / Huang, Eunice; Tolley, Elizabeth; Blakely, Martin L.; Langham, Max.

In: Annals of surgery, Vol. 257, No. 2, 01.02.2013, p. 371-375.

Research output: Contribution to journalArticle

@article{97b9481297174339b59041810805508a,
title = "Changes in hospital utilization and management of Hirschsprung disease: Analysis using the kids' inpatient database",
abstract = "OBJECTIVE: This study investigates how the epidemiology, hospital utilization, and surgical management of Hirschsprung disease (HD) have changed over the last decade in the United States, using a statistically valid national sample. BACKGROUND: HD is a congenital gastrointestinal disorder that requires surgical resection for correction. Some patients experience long-term bowel dysfunction requiring hospital care. Historically, patients had multiple staged operations, whereas more recently, single-stage laparoscopic resection and pull-through operations are more common. Assessment of possible changes over time in HD-associated complications requiring hospitalization and length of hospital stay has not been quantified epidemiologically. METHODS: The Kids' Inpatient Database was queried for all discharges with an International Classification of Disease, Ninth Revision, Clinical Modification code for HD in the years 1997, 2000, 2003, and 2006. The HD cohorts from these 4 time points were compared, specifically analyzing differences in demographic data, associated diagnoses, in-hospital mortality and length of stay, procedures performed during hospitalization, and frequency of hospitalizations for HD-associated complications. Results reported included estimated frequencies and means with 95{\%} confidence intervals. RESULTS: The estimated numbers of HD discharges, associated demographic data, and numbers of pull-through procedures have remained stable over the decade. The mean age (years) at the time of pull-through has decreased from 1.45 to 1.16 to 1.18 to 0.97 (P = 0.01). The mean length of stay (days) for these procedures has increased from 8.40 to 8.46 to 9.25 to 10.55 (P = 0.002). The estimated numbers of hospital admissions for HD-related constipation increased in recent years from 395 to 340 to 536 to 566 (P = 0.001). The estimated numbers of admissions for enterocolitis suggest an increasing trend from 466 to 402 to 584 to 556 (P = 0.11). CONCLUSIONS: HD pull-through procedures are being performed at younger ages over time, and post-pull-through lengths of stay have increased. Admissions for some HD-related complications have increased over the decade. Prospective cohort studies are needed to determine whether causal relationships exist among these trends.",
author = "Eunice Huang and Elizabeth Tolley and Blakely, {Martin L.} and Max Langham",
year = "2013",
month = "2",
day = "1",
doi = "10.1097/SLA.0b013e31827ee976",
language = "English (US)",
volume = "257",
pages = "371--375",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Changes in hospital utilization and management of Hirschsprung disease

T2 - Analysis using the kids' inpatient database

AU - Huang, Eunice

AU - Tolley, Elizabeth

AU - Blakely, Martin L.

AU - Langham, Max

PY - 2013/2/1

Y1 - 2013/2/1

N2 - OBJECTIVE: This study investigates how the epidemiology, hospital utilization, and surgical management of Hirschsprung disease (HD) have changed over the last decade in the United States, using a statistically valid national sample. BACKGROUND: HD is a congenital gastrointestinal disorder that requires surgical resection for correction. Some patients experience long-term bowel dysfunction requiring hospital care. Historically, patients had multiple staged operations, whereas more recently, single-stage laparoscopic resection and pull-through operations are more common. Assessment of possible changes over time in HD-associated complications requiring hospitalization and length of hospital stay has not been quantified epidemiologically. METHODS: The Kids' Inpatient Database was queried for all discharges with an International Classification of Disease, Ninth Revision, Clinical Modification code for HD in the years 1997, 2000, 2003, and 2006. The HD cohorts from these 4 time points were compared, specifically analyzing differences in demographic data, associated diagnoses, in-hospital mortality and length of stay, procedures performed during hospitalization, and frequency of hospitalizations for HD-associated complications. Results reported included estimated frequencies and means with 95% confidence intervals. RESULTS: The estimated numbers of HD discharges, associated demographic data, and numbers of pull-through procedures have remained stable over the decade. The mean age (years) at the time of pull-through has decreased from 1.45 to 1.16 to 1.18 to 0.97 (P = 0.01). The mean length of stay (days) for these procedures has increased from 8.40 to 8.46 to 9.25 to 10.55 (P = 0.002). The estimated numbers of hospital admissions for HD-related constipation increased in recent years from 395 to 340 to 536 to 566 (P = 0.001). The estimated numbers of admissions for enterocolitis suggest an increasing trend from 466 to 402 to 584 to 556 (P = 0.11). CONCLUSIONS: HD pull-through procedures are being performed at younger ages over time, and post-pull-through lengths of stay have increased. Admissions for some HD-related complications have increased over the decade. Prospective cohort studies are needed to determine whether causal relationships exist among these trends.

AB - OBJECTIVE: This study investigates how the epidemiology, hospital utilization, and surgical management of Hirschsprung disease (HD) have changed over the last decade in the United States, using a statistically valid national sample. BACKGROUND: HD is a congenital gastrointestinal disorder that requires surgical resection for correction. Some patients experience long-term bowel dysfunction requiring hospital care. Historically, patients had multiple staged operations, whereas more recently, single-stage laparoscopic resection and pull-through operations are more common. Assessment of possible changes over time in HD-associated complications requiring hospitalization and length of hospital stay has not been quantified epidemiologically. METHODS: The Kids' Inpatient Database was queried for all discharges with an International Classification of Disease, Ninth Revision, Clinical Modification code for HD in the years 1997, 2000, 2003, and 2006. The HD cohorts from these 4 time points were compared, specifically analyzing differences in demographic data, associated diagnoses, in-hospital mortality and length of stay, procedures performed during hospitalization, and frequency of hospitalizations for HD-associated complications. Results reported included estimated frequencies and means with 95% confidence intervals. RESULTS: The estimated numbers of HD discharges, associated demographic data, and numbers of pull-through procedures have remained stable over the decade. The mean age (years) at the time of pull-through has decreased from 1.45 to 1.16 to 1.18 to 0.97 (P = 0.01). The mean length of stay (days) for these procedures has increased from 8.40 to 8.46 to 9.25 to 10.55 (P = 0.002). The estimated numbers of hospital admissions for HD-related constipation increased in recent years from 395 to 340 to 536 to 566 (P = 0.001). The estimated numbers of admissions for enterocolitis suggest an increasing trend from 466 to 402 to 584 to 556 (P = 0.11). CONCLUSIONS: HD pull-through procedures are being performed at younger ages over time, and post-pull-through lengths of stay have increased. Admissions for some HD-related complications have increased over the decade. Prospective cohort studies are needed to determine whether causal relationships exist among these trends.

UR - http://www.scopus.com/inward/record.url?scp=84872287120&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872287120&partnerID=8YFLogxK

U2 - 10.1097/SLA.0b013e31827ee976

DO - 10.1097/SLA.0b013e31827ee976

M3 - Article

VL - 257

SP - 371

EP - 375

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 2

ER -