Herpes simplex virus testing and hospital length of stay in neonates and young infants.
OBJECTIVE
To examine whether ordering testing of cerebrospinal fluid (CSF) for herpes simplex virus (HSV) by polymerase chain reaction (PCR) in neonates and young infants is associated with increased hospital length of stay (LOS) or increased hospital charges.


METHODS
This retrospective cohort study enrolled infants age <or=56 days who underwent lumbar puncture in the emergency department in 2005-2006. The primary "exposure" was CSF HSV PCR, and the primary outcomes were LOS and hospital charges.


RESULTS
CSF HSV PCR was performed in 282 of 889 eligible infants (31.7%). The median test turnaround time was 22 hours. The median LOS was 2 days, and median hospital charge was $10 166. In multivariate analysis, CSF HSV PCR testing was associated with a LOS increase of 28% for infants age <or=28 days and 39% for infants age 29-56 days. LOS increased by 22% for every 12-hour increase in test turnaround time. CSF HSV PCR testing was associated with a 41% increase in hospital charges.


CONCLUSIONS
In infants evaluated by lumbar puncture in the emergency department, CSF HSV PCR testing was associated with a significantly longer LOS and higher hospital charges.
Shah
Samir S
SS
Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. shahs@email.chop.edu
Volk
Jessica
J
Mohamad
Zeinab
Z
Hodinka
Richard L
RL
Zorc
Joseph J
JJ
D002555:Cerebrospinal Fluid / Q000821:virology; D004636:Emergency Service, Hospital; D006561:Herpes Simplex / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000191:economics; D017722:Hospital Charges; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000191:economics; D016133:Polymerase Chain Reaction / Q000191:economics; D013129:Spinal Puncture / Q000191:economics