title: Hospital discharges for fever and neutropenia in pediatric cancer patients: United States, 2009.
abstract: BACKGROUND
  Fever and neutropenia (FN) is a common complication of pediatric cancer treatment, but hospital utilization patterns for this condition are not well described.
  
  
  METHODS
  Data were analyzed from the Kids' Inpatient Database (KID), an all-payer US hospital database, for 2009. Pediatric FN patients were identified using: age ≤19 years, urgent or emergent admit type, non-transferred, and a combination of ICD-9-CM codes for fever and neutropenia. Sampling weights were used to permit national inferences.
  
  
  RESULTS
  Pediatric cancer patients accounted for 1.5 % of pediatric hospital discharges in 2009 (n = 110,967), with 10.1 % of cancer-related discharges meeting FN criteria (n = 11,261). Two-fifths of FN discharges had a "short length of stay" (SLOS) of ≤3 days, which accounted for approximately $65.5 million in hospital charges. Upper respiratory infection (6.0 %) and acute otitis media (AOM) (3.7 %) were the most common infections associated with SLOS. Factors significantly associated with SLOS included living in the Midwest region (OR = 1.65, 1.22-2.24) or West region (OR 1.54, 1.11-2.14) versus Northeast, having a diagnosis of AOM (OR = 1.39, 1.03-1.87) or viral infection (OR = 1.63, 1.18-2.25) versus those without those comorbidities, and having a soft tissue sarcoma (OR = 1.47, 1.05-2.04), Hodgkin lymphoma (OR = 2.33, 1.62-3.35), or an ovarian/testicular tumor (OR = 1.76, 1.05-2.95) compared with patients without these diagnoses.
  
  
  CONCLUSIONS
  FN represents a common precipitant for hospitalizations among pediatric cancer patients. SLOS admissions are rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN.
authors.affiliation: Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, Suite 4099C, Indianapolis, IN, 46202, USA. elmuelle@iupui.edu.|Pediatric and Adolescent Comparative Effectiveness Research, Indiana University, Indianapolis, IN, 46202, USA. elmuelle@iupui.edu.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Mueller
authors.affiliation: Division of Pediatric Hematology Oncology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Walkovich
authors.affiliation: Division of Pediatric Hematology Oncology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Rajen
authors.initials: R
authors.lastname: Mody
authors.affiliation: Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Achamyeleh
authors.initials: A
authors.lastname: Gebremariam
authors.affiliation: Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, 48109, USA.|Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA.|Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, 48109, USA.|Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology*; D010351:Patient Discharge; D010372:Pediatrics; D014481:United States