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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


  • 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

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.


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.


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.


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