National Trends in Pediatric Basilar Skull Fractures

Abstract

Objectives: (1) Identify the current public health burden of pediatric temporal bone fractures. (2) Determine if the introduction of bicycle helmet and child safety seat laws has resulted in a change in national patterns. Methods: The 2000 and 2009 Kids’ Inpatient Databases were used to gather data on a sample of all pediatric discharges in the United States during the years 2000 and 2009. Children diagnosed with basilar skull fractures were identified by corresponding ICD-9 codes. Database analyses generated national estimates of summary statistics and comparison of trends over the 9-year period. Results: The estimated prevalence of pediatric skull base fractures requiring hospitalization in the United States has remained essentially stable with 9641 (95% confidence interval [CI]: 8782, 10,501) admissions in 2000 and 10,581 (95% CI: 9532, 11,630) in 2009. Likewise, the mean age is unchanged from 10.02 (95% CI: 9.66, 10.38) years to 9.76 (95% CI: 9.44, 10.07). The proportion of female patients is the same (33%) (95% CI: 0.031, 0.34) and (95% CI: 0.0.32, 0.35) respectively. Total charges increased from $25,900,000 (95% CI: $22,200,000, $29,600,000) to $60,300,000 (95% CI: $53,100,000, $67,600,000) with a mean charge per admission increasing from $28,958 (95% CI: $26,302, $31,615) in 2000 to $57,596 (95% CI: $53,134, $62,058) in 2009. The mean length of stay remained stable at 6.04 (95% CI: 5.60, 6.48) to 5.31 (95% CI: 5.00, 5.62) hospital days. Conclusions: The public health impact of pediatric skull base fractures continues to be substantial. Despite the institution of bicycle helmet and child safety seat laws, national trends demonstrate a stable prevalence of hospital admissions, age at admission, sex distribution, and mean hospital stays with an increasing economic burden over the past decade.