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Arch Pediatr Adolesc Med. 2008 Jan;162(1):44-8. doi: 10.1001/archpediatrics.2007.10.

Primary operative management for pediatric empyema: decreases in hospital length of stay and charges in a national sample.

Author information

  • 1Department of Pediatrics, University of California Davis, 2516 Stockton Blvd, Sacramento, CA 95817, USA. su-ting.li@ucdmc.ucdavis.edu

Erratum in

  • Arch Pediatr Adolesc Med. 2010 Jun;164(6):553.

Abstract

OBJECTIVE:

To determine whether primary operative management (decortication within the first 2 days of hospitalization) decreases hospital length of stay (LOS) and total charges in children with empyema.

DESIGN:

Retrospective cohort study.

SETTING:

Nationally representative Kids' Inpatient Database for 2003.

PARTICIPANTS:

Children and adolescents aged 0 to 18 years (hereinafter referred to as children) with empyema.

MAIN OUTCOME MEASURES:

Hospital LOS and total charges.

RESULTS:

A total of 1173 children with empyema were identified. Compared with children treated with primary nonoperative management, children treated with primary operative management had a shorter hospital LOS by 4.3 (95% confidence interval [CI], 2.3-6.4) days and lower total hospital charges by $21,179.80 (95% CI, -$34,111.12 to -$8248.48) and were less likely to be transferred to another short-term hospital (0% vs 13.3%). In addition, children with primary operative management were less likely to have therapeutic failure (odds ratio, 0.08 [95% CI, 0.04-0.15]). There was no difference in complications between the 2 groups (odds ratio, 1.01 [95% CI, 0.59-1.74]).

CONCLUSION:

Primary operative management is associated with decreased LOS, hospital charges, and likelihood of transfer to another short-term hospital, compared with nonoperative management.

Comment in

  • Hold those scalpels. [Arch Pediatr Adolesc Med. 2008]
PMID:
18180411
[PubMed - indexed for MEDLINE]
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