Category
Applied
Description
The prevalence of chronic disease among children in the United States has increased substantially over the past two decades. Children with chronic disease experience higher morbidity, mortality, and healthcare utilization, disparities that may be amplified following traumatic injury. However, nationally representative longitudinal data examining these associations remains limited. We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project Kids’ Inpatient Database (HCUP-KID) from 2000 to 2019. Pediatric patients (=18 years) hospitalized for traumatic injury were identified using ICD-9-CM and ICD-10-CM codes. Chronic conditions were classified using the HCUP Chronic Condition Indicator and grouped into major diagnostic categories. Outcomes included in-hospital mortality, length of stay (LOS), and total hospital charges. Multivariable logistic and linear regression models were used to estimate adjusted associations, controlling for demographic and socioeconomic factors. A total of 545,249 pediatric trauma hospitalizations were included. The prevalence of chronic conditions increased over time and was highest among adolescents. Outcomes varied significantly by chronic condition burden: mortality increased from 0.40% among patients without chronic conditions to 14.25% among those with =2 conditions (p < 0.001), with corresponding increases in LOS and total hospital charges. Neurologic (OR = 19.59), circulatory (OR = 8.02), and blood conditions (OR = 6.36) were associated with the highest mortality risk and increases in LOS and hospital charges. Adolescents also demonstrated higher mortality and utilization compared to younger children. These findings highlight a growing clinical and economic burden and underscore the need for targeted strategies to improve outcomes in high-risk pediatric trauma populations.
Association Between Preexisting Chronic Conditions and Hospital Outcomes Among Pediatric Trauma Patients in the United States, 2000-2019
Applied
The prevalence of chronic disease among children in the United States has increased substantially over the past two decades. Children with chronic disease experience higher morbidity, mortality, and healthcare utilization, disparities that may be amplified following traumatic injury. However, nationally representative longitudinal data examining these associations remains limited. We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project Kids’ Inpatient Database (HCUP-KID) from 2000 to 2019. Pediatric patients (=18 years) hospitalized for traumatic injury were identified using ICD-9-CM and ICD-10-CM codes. Chronic conditions were classified using the HCUP Chronic Condition Indicator and grouped into major diagnostic categories. Outcomes included in-hospital mortality, length of stay (LOS), and total hospital charges. Multivariable logistic and linear regression models were used to estimate adjusted associations, controlling for demographic and socioeconomic factors. A total of 545,249 pediatric trauma hospitalizations were included. The prevalence of chronic conditions increased over time and was highest among adolescents. Outcomes varied significantly by chronic condition burden: mortality increased from 0.40% among patients without chronic conditions to 14.25% among those with =2 conditions (p < 0.001), with corresponding increases in LOS and total hospital charges. Neurologic (OR = 19.59), circulatory (OR = 8.02), and blood conditions (OR = 6.36) were associated with the highest mortality risk and increases in LOS and hospital charges. Adolescents also demonstrated higher mortality and utilization compared to younger children. These findings highlight a growing clinical and economic burden and underscore the need for targeted strategies to improve outcomes in high-risk pediatric trauma populations.
