title: Impact of urinary tract infection on inpatient healthcare for congenital obstructive uropathy.
abstract: OBJECTIVE
  Congenital obstructive uropathy (COU) is a leading cause of pediatric chronic kidney disease (CKD). Urinary tract infections (UTIs) pose a risk for ascending infections and CKD in patients with COU. We evaluated the impact of comorbid UTIs on hospital charges and length of stay (LOS) for pediatric COU discharges.
  
  
  METHODS
  The study sample (n = 2832) was drawn from the 2003 and 2006 US Healthcare Cost and Utilization Project Kids' Inpatient Database. Data were analyzed using logistic and linear regression.
  
  
  RESULTS
  Comorbid UTIs complicated 6.7% of COU discharges, and were most common in patients with posterior urethral valves (15.7% of discharges). Comorbid UTIs increased mean charges by $7910 (95% confidence interval (CI) $4770-$11,040; p < 0.001) and prolonged mean LOS by 2.66 days (95% CI 2.03-3.29; p < 0.001) compared to COU discharges without UTI. After controlling for LOS, charges for COU with a secondary diagnosis of UTI were no longer significantly higher. Mean charges in inflation-adjusted dollars increased by $2710, a 15.8% increase unexplained by covariate diagnoses and procedures.
  
  
  CONCLUSIONS
  Comorbid UTIs contribute significantly to inpatient charges for COU, by prolonging LOS.
authors: Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43201, USA. Michael.Becknell@nationwidechildrens.org
authors: Brian
authors: B
authors: Becknell
authors: David S
authors: DS
authors: Hains
authors: Andrew L
authors: AL
authors: Schwaderer
authors: Brian A
authors: BA
authors: Vanderbrink
authors: John David
authors: JD
authors: Spencer
authors: Patricia B
authors: PB
authors: Reagan
authors: Kirk M
authors: KM
authors: McHugh
mesh_terms: D003695:Delivery of Health Care / Q000191:economics*; D017722:Hospital Charges / Q000639:trends*; D006760:Hospitalization / Q000191:economics*; D006764:Hospitals, Community / Q000191:economics; D006801:Humans; D007297:Inpatients; D007668:Kidney / Q000002:abnormalities*; D007674:Kidney Diseases / Q000150:complications / Q000151:congenital* / Q000191:economics; D007902:Length of Stay / Q000191:economics; D012189:Retrospective Studies; D014481:United States; D014552:Urinary Tract Infections / Q000191:economics* / Q000209:etiology; D055815:Young Adult