This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Surgery  • Adolescent Medicine  • Pediatrics, Other  • Alert me on articles by topic

Decreases in Hospital Length of Stay and Charges in a National Sample

Su-Ting T. Li, MD, MPH; Robert L. Gates, MD

Arch Pediatr Adolesc Med. 2008;162(1):44-48.

Objective  To determine whether primary operative management (decortication within the first 2 days of hospitalization) decreases hospital length of stay (LOS) and total charges in children with empyema.

Design  Retrospective cohort study.

Setting  Nationally representative Kids' Inpatient Database for 2003.

Participants  Children and adolescents aged 0 to 18 years (hereinafter referred to as children) with empyema.

Main Outcome Measures  Hospital LOS and total charges.

Results  A total of 1173 children with empyema were identified. Compared with children treated with primary nonoperative management, children treated with primary operative management had a shorter hospital LOS by 4.3 (95% confidence interval [CI], 2.3-6.4) days and lower total hospital charges by $21 179.80 (95% CI, –$34 111.12 to –$8248.48) and were less likely to be transferred to another short-term hospital (0% vs 13.3%). In addition, children with primary operative management were less likely to have therapeutic failure (odds ratio, 0.08 [95% CI, 0.04-0.15]). There was no difference in complications between the 2 groups (odds ratio, 1.01 [95% CI, 0.59-1.74]).

Conclusion  Primary operative management is associated with decreased LOS, hospital charges, and likelihood of transfer to another short-term hospital, compared with nonoperative management.

Author Affiliations: Departments of Pediatrics (Dr Li) and Surgery (Dr Gates), University of California Davis, Sacramento.