Pediatric penetrating cervical trauma in HCUP: Associations with hospital length of stay and cost

Abstract

ObjectiveTo describe pediatric penetrating cervical trauma (PCT) and determine factors associated with increased length of stay (LOS) and total hospital charges. Study designRetrospective review of Healthcare Cost and Utilization Project (HCUP) from the Kids’ Inpatient Database (KID) for 2016. SettingPublic database. MethodsA retrospective analysis of the HCUP from the KID for 2016 for inpatients ≤18 years of age. Comparisons between PCT and non-PCT patients were made, including hospital LOS and total charges. ResultsThere were 1279 patients with neck trauma of which 686 (53.6%) were identified as sustaining PCT. Patients with PCT were older (13.2 vs 11.8 yr, p = .001), and were more likely to be male (65.9% vs 54.8%, p < .001) and African-American (21.9% vs 15.9, p = .01). PCT patients were less likely to have a vascular injury (6.1% vs 20.1%, p < .001) and they were more likely to undergo airway evaluation (8.3% vs 2.2%, p < .001). Within the PCT group, 11.5% had open pharyngeal/esophageal lacerations, 6.1% had open tracheal injuries, 2.0% had open thyroid injuries, and 1.6% had open laryngeal injuries. LOS and total charges were not different between children with and without PCT (mean LOS 6.5 days, mean total charges US$106,000). Linear regression analysis showed significant associations with LOS for age, tracheal open injuries, cervical or vascular injury, and undergoing airway evaluation and/or esophagoscopy. Total charges associations were similar. ConclusionLOS and total charges were not different in children with PCT and non-PCT, but both were increased when there were more cervical injuries and more related procedures done.