Coronary Artery DiseaseFactors Associated With Resource Utilization and Coronary Artery Dilation in Refractory Kawasaki Disease (from the Pediatric Health Information System Database)
Section snippets
Methods
For this retrospective, observational cohort study, data were obtained from the Pediatric Health Information System (PHIS). The PHIS database was queried for patients aged ≤18 years discharged with KD (International Classification of Diseases, Ninth Revision, code: 446.1) and a medication charge for IVIG from January 1, 2004, to March 31, 2014. PHIS is a large, inpatient, administrative database which obtains information from 45 tertiary care, free-standing, not-for-profit pediatric hospitals
Results
Of the 14,194 patients identified as having KD, 2,974 (21%) received >1 dose of IVIG and formed the refractory KD study group (62% men). Compared to the responsive KD cohort, patients with refractory KD were older, had longer hospital LOS, and higher total hospital charges (Table 1, p <0.01 for all). Medicaid and private insurance were the most common providers for both KD groups. The proportion of patients admitted for refractory KD was highest in the south (37%) and the lowest was in the
Discussion
This study showed wide practice variation in PHIS hospitals in the use of immunomodulator therapy for patients with refractory KD. Consistent with a previous report that IVIG was the most common (65%) initial medication chosen to treat patients with refractory KD,11 it was the only medication used for a larger proportion (77%) in this PHIS database study. The previous investigators also reported greater use of solumedrol and infliximab than that in our study (27% vs 18% and 8% vs 2%,
Disclosures
The authors have no conflicts of interest to disclose.
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Funding: This investigation was supported by the University of Utah Study Design and Biostatistics Center, with funding in part through Grant 5UL1TR001067-02 (formerly 8UL1TR000105 and UL1RR025764) from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health.
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