ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1964

Factors Associated with High-Cost Hospitalizations for Hemodialysis Catheter-Associated Blood Stream Infections in Children

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Wasik, Heather L., State University of New York Upstate Medical University, Syracuse, New York, United States
  • Neu, Alicia, Johns Hopkins University, Baltimore, Maryland, United States
  • Warady, Bradley A., Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
  • Crawford, Brendan, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
  • Richardson, Troy, Children's Hospital Association, Overland Park, Kansas, United States
  • De Souza, Heidi G., Children's Hospital Association, Overland Park, Kansas, United States
  • Cardwell, Diana, Children's Health Children's Medical Center Dallas, Dallas, Texas, United States
  • Ruebner, Rebecca, Johns Hopkins University, Baltimore, Maryland, United States

Group or Team Name

  • The Standardized Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative
Background

Hospitalizations of adults for hemodialysis catheter-associated blood stream infections (HD-BSI) lead to high costs. No studies have evaluated hospitalization costs for HD-BSI in children or identified factors associated with high-costs.

Methods

The Standardized Care to Improve Outcomes in Pediatric End-Stage Kidney Disease (SCOPE) collaborative database was used to identify HD-BSI. SCOPE database linked to the Pediatric Health Information Systems (PHIS) database which provided hospitalization billing data. High-cost hospitalization defined as cost above 50th percentile in our study population. Multivariable logistic regression used to assess the relationship between high-cost hospitalization and patient and clinical characteristics.

Results

The median(IQR) LOS for HD-BSI hospitalization was 5(3-10) days. The median(IQR) cost for HD-BSI hospitalization was $18,375($11,584-$36,266). Cost for each service line was higher in high-cost group(p<0.001)(Figure 1). High-cost HD-BSI hospitalization was associated with ICU stay, LOS, need for catheter replacement/rewiring(Table 1). ICU stay (aOR=4.84, 95% CI 1.66-14.08, p=0.004) and need for catheter procedure (aOR 6.29, 95% CI 2.76-14.35, p<0.001) remained associated with high-cost hospitalization in a multivariable model.

Conclusion

Hospitalizations of children for HD-BSI lead to high costs. Efforts to prevent HD-BSI may reduce the costs of caring for children on hemodialysis.

Figure 1

Table 1