Cachexia & debility diagnoses in hospitalized children and adolescents with complex chronic conditions: evidence from the Kids’ Inpatient Database

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Abstract

Objective: To characterize the frequency, cost, and hospital-reported outcomes of cachexia and debility in children and adolescents with complex chronic conditions (CCCs).

Methods: We identified children and adolescents (aged ≤20 years) with CCCs, cachexia, and debility in the Kids’ Inpatient Database [Healthcare Cost and Utilization Project, Agency for Healthcare Research & Quality]. We then compared the characteristics of patients and hospitalizations, including cost and duration of stay, for CCCs with and without cachexia and/ or debility. We examined factors that predict risk of inpatient mortality in children and adolescents with CCCs using a logistic regression model. We examined factors that impact duration of stay and cost in children and adolescents with CCCs using negative binomial regression models. All costs are reported in US dollars in 2014 using Consumer Price Index inflation adjustment.

Results: We estimated the incidence of hospitalization of cachexia in children and adolescents with CCCs at 1,395 discharges during the sample period, which ranged from 277 discharges in 2003 to 473 discharges in 2012. We estimated the incidence of hospitalization due to debility in children and adolescents with CCCs at 421 discharges during the sample period, which ranged from 39 discharges in 2003 to 217 discharges in 2012. Cachexia was associated with a 60% increase in the risk of inpatient mortality, whereas debility was associated with a 40% decrease in the risk of mortality. Cachexia and debility increased duration of stay in hospital (17% and 39% longer stays, respectively). Median cost of hospitalization was $15,441.59 and $23,796.16 for children and adolescents with cachexia and debility, respectively.

Conclusions: Incidence of hospitalization for cachexia in children and adolescents with CCCs is less than that for adults but the frequency of cachexia diagnoses increased over time. Estimates of the incidence of hospitalization with debility in children and adolescents with CCCs have not been reported, but our study demonstrates that the frequency of these discharges is also increasing.

Keywords: adolescent, cachexia, child, complex chronic conditions, cost analysis, debility, HIV, pediatrics.

Abbreviations: CCCs, complex chronic conditions; HIV, human immunodeficiency virus; KID, Kids’ Inpatient Database; PDD, primary discharge diagnosis; TNF-α, tumor necrosis factor-alpha

Citation
Van Doren BA, Roy D, Noone JM, Blanchette CM, Arthur ST. Cachexia & debility diagnoses in hospitalized children and adolescents with complex chronic conditions: evidence from the Kids’ Inpatient Database. Drugs in Context 2015; 4: 212277. doi: 10.7573/dic.212277

Copyright
Copyright © 2015 Van Doren BA, Roy D, Noone JM, Blanchette CM, Arthur ST. Distributed under the terms of the Creative Commons License Deed CC BY NC ND 3.0 which allows anyone to copy, distribute, and transmit the articles provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution
Copyright © 2015 Van Doren BA, Roy D, Noone JM, Blanchette CM, Arthur ST. http://dx.doi.org/10.7573/dic.212277. Published by Drugs in Context under Creative Commons Attributions License Deed CC BY NC ND 3.0.

Article URL
https://www.drugsincontext.com/cachexia-debility-diagnoses-hospitalized-children-adolescents-complex-chronic-conditions-evidence-kids-inpatient-database 

Correspondence
Bryce A Van Doren, University of North Carolina at Charlotte, College of Health and Human Services, 9201 University City Blvd, Charlotte, NC 28223, USA. bvandore@uncc.edu

Provenance
Submitted, externally peer reviewed

Dates
Submitted: 27 January 2015
Revised manuscript submitted: 17 February 2015
Publication date: 27 February 2015

Publisher and contact information
Drugs in Context is published by Just Medical Media Ltd
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