title: Primary operative management for pediatric empyema: decreases in hospital length of stay and charges in a national sample.
abstract: OBJECTIVE
  To determine whether primary operative management (decortication within the first 2 days of hospitalization) decreases hospital length of stay (LOS) and total charges in children with empyema.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Nationally representative Kids' Inpatient Database for 2003.
  
  
  METHODS
  Children and adolescents aged 0 to 18 years (hereinafter referred to as children) with empyema.
  
  
  METHODS
  Hospital LOS and total charges.
  
  
  RESULTS
  A total of 1173 children with empyema were identified. Compared with children treated with primary nonoperative management, children treated with primary operative management had a shorter hospital LOS by 4.3 (95% confidence interval [CI], 2.3-6.4) days and lower total hospital charges by $21,179.80 (95% CI, -$34,111.12 to -$8248.48) and were less likely to be transferred to another short-term hospital (0% vs 13.3%). In addition, children with primary operative management were less likely to have therapeutic failure (odds ratio, 0.08 [95% CI, 0.04-0.15]). There was no difference in complications between the 2 groups (odds ratio, 1.01 [95% CI, 0.59-1.74]).
  
  
  CONCLUSIONS
  Primary operative management is associated with decreased LOS, hospital charges, and likelihood of transfer to another short-term hospital, compared with nonoperative management.
authors.affiliation: Department of Pediatrics, University of California Davis, 2516 Stockton Blvd, Sacramento, CA 95817, USA. su-ting.li@ucdmc.ucdavis.edu
authors.forename: Su-Ting T
authors.initials: ST
authors.lastname: Li
authors.forename: Robert L
authors.initials: RL
authors.lastname: Gates
mesh_terms: D015505:Chest Tubes / Q000706:statistics & numerical data; D002648:Child; D015331:Cohort Studies; D016724:Empyema, Pleural / Q000191:economics* / Q000601:surgery*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000706:statistics & numerical data; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D005343:Fibrinolytic Agents