Modern Trends in Demographics and Inpatient Healthcare Utilization for Hemolytic Uremic Syndrome in the U.S.A.

Abstract

Background Hemolytic-uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury. Extrarenal manifestations complicate HUS, damaging the gastrointestinal tract, central nervous system, and respiratory tract. Despite potentially serious sequelae, few studies have characterized demographics, clinical outcomes, and economic burden of HUS in the US. Methods Pediatric admissions with a primary diagnosis of HUS between 2000-2009 were evaluated via the Kids' Inpatient Database of the Healthcare Utilization Project. Results From 2000-2009, 1133 children were hospitalized annually with HUS. Overall hospital length of stay (LOS) decreased significantly. Females predominated (53.7%) and 49.1% of patients were 1-4 years of age. Extrarenal manifestations were associated with increased likelihood of dialysis. Almost one-third received red blood cell (RBC) transfusions, and RBC transfusion frequency increased over time. Overall mortality rate was 2.4% and significantly decreased over time. Neurological and respiratory complications and sepsis were associated with increased mortality. Conclusions Despite serious complications associated with HUS, there is a lack of data describing demographics and impact of HUS on the US healthcare system. This study provides the largest review of HUS cases and provides impetus to prospectively evaluate interventions that reduce morbidity and mortality in HUS patients.