Impact of bacterial meningitis-associated conditions on pediatric inpatient resource utilization.
OBJECTIVE
To define the epidemiology of systemic complications and focal infections associated with bacterial meningitis and quantify how the presence of such complications affects in-hospital healthcare resource utilization.


METHODS
Retrospective cohort study using administrative data from 27 children's hospitals. Children <18 years of age diagnosed with bacterial meningitis from 2001 to 2006 were eligible. The primary exposure of interest was the presence of a bacterial meningitis-associated condition, classified as either systemic complications (eg, sepsis), associated focal infections (eg, pneumonia) or both. The primary outcomes were total in-hospital charges and length of stay (LOS).


RESULTS
A total of 574 of 2319 (25%) of children had a systemic complication or an associated focal infection. Compared with children without complications, in-hospital charges were significantly higher in children with systemic complications (136% increase), associated focal infections (118% increase), and both conditions (351% increase). LOS was also significantly increased in those with systemic complications (by 72%), associated focal infections (by 78%), or both conditions (by 211%). The presence of systemic complications was more common in younger children while the presence of an associated focal infection was more common in older children.


CONCLUSIONS
Children with bacterial meningitis often have additional morbidity due to systemic complications or associated focal infections indicated by increase use of acute in-hospital resource utilization. The apparent increase in in-hospital morbidity related to these conditions should be considered in future evaluations of vaccine efficacy, novel therapeutics, and hospital resource allocation.
Mongelluzzo
Jillian
J
Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
Mohamad
Zeinab
Z
Ten Have
Thomas R
TR
Shah
Samir S
SS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005490:Focal Infection / Q000191:economics / Q000453:epidemiology / Q000382:microbiology*; D017722:Hospital Charges / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D018805:Sepsis / Q000191:economics / Q000453:epidemiology / Q000382:microbiology*