Abstract
Purpose
This study aimed to define morbidities and costs related to modern-day medical care for children with vascular anomalies.
Methods
We reviewed the 2003–2009 Kids’ Inpatient Database for pediatric patients (age < 21 years) hospitalized with hemangioma, arteriovenous malformation (AVM), or lymphatic malformation (LM). Patient characteristics, hospital complications, and hospital charges were compared by vascular anomaly type. Multivariable linear regression modeling was used to determine predictors of increasing hospital costs for patients with AVMs.
Results
In total, 7485 pediatric inpatients with vascular anomalies were identified. Frequently associated complications included chronic anemia (4.0%), sepsis (4.6%), and hypertension (2.4%). Children with AVM had the highest rate of in-hospital mortality, compared to those with hemangiomas or LM (1.0% vs. 0.1% vs. 0.3%, p < 0.001). AVMs were also associated with the highest median hospital charge, more than twice the cost for hemangiomas or LM ($45,875 vs. $18,909 vs. $18,919; p < 0.001).
Conclusions
There is a significant rate of morbidity in children with vascular anomalies, most often from blood loss and infection. The greater cost of AVM care may be related to the higher mortality rate, associated complications, and complexity of procedures required treating them. Cost-effective management of vascular anomalies should target prevention and the early recognition of both chronic comorbidities and acute complications.
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This work was presented as an oral presentation at the Association for Academic Surgery/Society of University Surgeons Academic Surgical Congress in Jacksonville, Florida on February 4th, 2016. This study was presented at the 5th World Congress of the World Federation of Associations of Pediatric Surgeons in Washington D.C. on October 10, 2016.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent was not required.
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Kim, J., Sun, Z., Leraas, H.J. et al. Morbidity and healthcare costs of vascular anomalies: a national study. Pediatr Surg Int 33, 149–154 (2017). https://doi.org/10.1007/s00383-016-4007-x
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DOI: https://doi.org/10.1007/s00383-016-4007-x