title: Pediatric traumatic amputations and hospital resource utilization in the United States, 2003.
abstract: BACKGROUND
  Despite the severity of consequences associated with traumatic amputation, little is known about the epidemiology or healthcare resource burden of amputation injuries, and even less is known about these injuries in the pediatric population.
  
  
  METHODS
  An analysis of patients aged < or =17 years hospitalized with traumatic amputations using the 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database was performed. National estimates of amputation-associated hospitalizations, rates, resource use, and demographics were calculated. Potentially significant covariate associations were studied using hospital charges and length of stay (LOS).
  
  
  RESULTS
  In 2003, 956 cases of traumatic amputations among children aged < or =17 years resulted in 21.6 million dollars (standard deviation [SD] = 2.2 million dollars) in inpatient charges and 3,967 days (SD = 354) of hospitalization in the United States. Finger and/or thumb amputations accounted for the majority of injuries (64.0%). Mean (SD) hospital charges and LOS were 23,157 dollars (49,018 dollars) and 4.1 (7.4) days, respectively. Traumatic leg amputations incurred the highest mean hospital charges (120,275 dollars) and longest mean LOS (18.5 days). Older children (15-17 years) experienced a higher hospitalization rate (1.84/100,000) than other age groups. Older age, amputation caused by a motorized vehicle, urban hospital location, children's hospital type, and longer LOS were associated with higher total charges. Amputation caused by lawn mower, motorized vehicle or explosives/fireworks, and children's hospital type were associated with longer LOS.
  
  
  CONCLUSIONS
  Pediatric traumatic amputations contribute substantially to the health resource burden in the United States, resulting in 21 million dollars in inpatient charges annually. More effective interventions to prevent these costly injuries among children must be implemented.
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio 43205, USA.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Conner
authors.forename: Lara B
authors.initials: LB
authors.lastname: McKenzie
authors.forename: Huiyun
authors.initials: H
authors.lastname: Xiang
authors.forename: Gary A
authors.initials: GA
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000673:Amputation, Traumatic / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005121:Extremities / Q000293:injuries; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D017722:Hospital Charges; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D014481:United States / Q000453:epidemiology