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    The Top 25 Comorbidities Reported During Inpatient Stays for Pediatric Hematopoietic Stem Cell Transplant: Patient Demographics and Impact on Inpatient Mortality and Charges

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    Author
    Zulueta, Stacy
    Clemans, Emily
    Skrepnek, Grant
    Affiliation
    College of Pharmacy, The University of Arizona
    Issue Date
    2011
    Keywords
    comorbidities
    hematopoietic stem cell transplant
    pediatric
    mortality
    Healthcare Cost and Utilization Project (HCUP)
    MeSH Subjects
    Hematopoietic Stem Cell Transplantation
    Comorbidity
    Hospital Charges
    Hospital Mortality
    Advisor
    Skrepnek, Grant
    
    Metadata
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    Rights
    Copyright © is held by the author.
    Collection Information
    This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.
    Publisher
    The University of Arizona.
    Abstract
    OBJECTIVES: The purpose of this study was to analyze the impact of patient and hospital characteristics as well as selected comorbidities on inpatient mortality and charges in pediatric HSCT. We have determined the top 25 comorbidities reported during all inpatient stays for HSCT as well as for those stays ending in mortality. METHODS: All data was extracted from the AHRQ KID databases for the years 1997, 2000, 2003, and 2006. Two regression analyses were performed to determine the contribution of various independent variables on mortality and charges. Subjects of this study included all cases of HSCT reported in the Healthcare Cost and Utilization Project (HCUP) KID as ICD-9 41.XX. RESULTS: Factors accounting for larger increases in cost included death during hospital stay, the development of disseminated intravascular coagulation (DIC), pneumonia, and length of stay (LOS). The largest decreases in charges were seen for patients coming from a small or “micropolitan” location, patients cared for in teaching hospitals, and in hospitals with large bedsizes. Variables associated with increased risk of mortality on linear regression included development of DIC, sepsis, or pneumonia. CONCLUSION: Further study relating to HSCT is necessary to determine the contribution of specific comorbidities to mortality and charges. Importantly, DIC is associated with both greater risk of mortality and greater charges. It would be prudent to recommend increased monitoring and early treatment for DIC based on these results.
    Description
    Class of 2011 Abstract
    Collections
    Pharmacy Student Research Projects

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