Cyclic Vomiting Syndrome-Related Hospitalizations Trends, Comorbidities & Health Care Costs in Children: A Population Based Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Population
2.2. Study Variables
2.3. Statistical Analysis
3. Results
3.1. Demographics and Clinical Characteristics of CVS and Non-CVS Patients
3.2. Trends in CVS-Related Hospitalization
3.3. GI Procedures, Costs and Length of Hospital Stay
3.4. Factors Associated with CVS on Multivariate Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Demographics | CVS N = 12,396 | Controls N = 60,735 | p Value |
---|---|---|---|
Age | 10.51 ± 6.7 | 10.61 ± 7.8 | 0.15 |
Sex Male Female | 5352 (43.2%) 7044 (56.8%) | 26,115 (43%) 34,619 (57%) | 0.73 |
Race White African American Hispanic Others | 6117 (49.3%) 1481 (11.9%) 1628 (13.1%) 3170 (25.6%) | 25,738 (42.4%) 8522 (14%) 11,383 (18.7%) 15,092 (24.9%) | <0.001 |
Insurance Public Private Self-pay/Uninsured/others | 4989 (40.2%) 6336 (51.1%) 1071 (8.7%) | 29,045 (47.8%) 26,256 (43.2%) 5434 (9%) | <0.001 |
Bed Size of Hospital Small Medium Large | 1677 (13.8%) 3509 (29%) 6926 (57.2%) | 7403 (12.4%) 15,247 (25.6%) 36,843 (61.9%) | <0.001 |
Location/Teaching status Rural Urban—Nonteaching Urban Teaching | 1495 (12.3%) 2866 (23.7%) 7752 (64%) | 6391 (10.7%) 17,912 (30.1%) 35,191 (59.3%) | <0.001 |
Region of Hospital Northeast Midwest South West | 2519 (20.3%) 2803 (22.6%) 4185 (33.8%) 2889 (23.3%) | 10,347 (17%) 13,911 (22.9%) 23,672 (39%) 12,805 (21.1%) | <0.001 |
Elective hospitalizations | 1249 (10.1%) | 10,457 (17.3%) | <0.001 |
Comorbid Conditions | |||
Irritable bowel syndrome | 124 (1%) | 83 (0.1%) | <0.001 |
Migraine | 697 (5.6%) | 457 (0.8%) | <0.001 |
Dysautonomia | 69 (0.6%) | 19 (<0.1%) | <0.001 |
Gastroesophageal reflux disease | 1747 (14.1%) | 1344 (2.2%) | <0.001 |
Obesity | 255 (2.1%) | 1122 (1.8%) | 0.16 |
Dyspepsia | 238 (1.9%) | 66 (0.1%) | <0.001 |
Substance Abuse | |||
Narcotic use | 64 (0.5%) | 255 (0.4%) | 0.13 |
Alcohol use | 58 (0.7%) | 575 (0.9%) | 0.006 |
Cannabis use | 745 (6%) | 849 (1.4%) | <0.001 |
Smoking | 531 (4.3%) | 1589 (2.6%) | <0.001 |
Mental Health Disorders | |||
Depression | 532 (4.3%) | 2461(4.1%) | 0.22 |
Anxiety | 967 (7.8%) | 1119 (1.8%) | <0.001 |
Adjustment disorder | 173 (1.4%) | 839 (1.4%) | 0.90 |
Stress reaction | 25 (0.2%) | 38 (0.1%) | <0.001 |
Post-traumatic stress disorder | 81 (0.7%) | 534 (0.9%) | 0.01 |
Bipolar Disorder | 140 (1.1%) | 1042 (1.7%) | <0.001 |
Procedures/Outcomes | CVS N = 12,624 | Controls N = 60,735 | p Value |
---|---|---|---|
Esophagogastroduodenoscopy | 1288 (10.4%) | 478 (0.8%) | <0.001 |
Colonoscopy | 135 (1.1%) | 208 (0.3%) | <0.001 |
Length of hospital stay (days) | 3.03 ± 0.03 | 3.79 ± 0.03 | <0.001 |
Total Charges (in dollars) | 14,225 ± 197 | 21,181 ± 272 | <0.001 |
Total cost | 4974 ± 71 | 6925 ± 88 | <0.001 |
Discharge Routine Against Medical Advice | 11,581 (93.4%) 155 (1.3%) | 56,910 (93.7%) 191 (0.3%) | 0.13 <0.001 |
Mortality | IS (<0.1%) | 144 (0.4%) | <0.001 |
Parameters | OR | 95% Confidence Interval | p Value |
---|---|---|---|
Race White African American vs. White Hispanic vs. White Others vs. White | Ref 0.87 0.72 0.95 | Ref 0.81 to 0.93 0.67 to 0.76 0.90 to 1.004 | Ref <0.001 <0.001 0.068 |
Insurance Public Private vs. public Self-pay/Insured vs. public | Ref 1.25 1.05 | Ref 1.19 to 1.31 0.97 to 1.14 | Ref <0.001 0.17 |
Hospital Bed Size Small Medium vs. Small Large vs. Small | Ref 1.005 0.79 | Ref 0.93 to 1.07 0.75 to 0.85 | Ref 0.19 <0.001 |
Teaching Status Rural Urban nonteaching vs. rural Urban teaching vs. rural | Ref 0.63 0.81 | Ref 0.58 to 0.67 0.75 to 0.86 | Ref <0.001 <0.001 |
Location Northeast Midwest vs. Northeast South vs. Northeast West vs. Northeast | Ref 0.76 0.79 1.03 | Ref 0.71 to 0.82 0.75 to 0.84 0.96 to 1.1 | Ref <0.001 <0.001 0.38 |
Year 2003 2006 vs. 2003 2009 vs. 2003 2012 vs. 2003 2016 vs. 2003 | Ref 0.97 0.88 0.89 0.48 | Ref 0.91 to 1.03 0.83 to 0.94 0.89 to 1.01 0.45 to 0.52 | Ref 0.35 <0.001 0.14 <0.001 |
Irritable bowel syndrome | 2.08 | 1.2 to 4.31 | <0.001 |
Migraine | 6.79 | 5.96 to 7.74 | <0.001 |
Dysautonomia | 12.08 | 7.003 to 20.844 | <0.001 |
Gastroesophageal reflux disease | 6.9 | 6.4 to 7.51 | <0.001 |
Dyspepsia | 11.89 | 8.82 to 16.03 | <0.001 |
Alcohol use | 0.29 | 0.22 to 0.38 | <0.001 |
Cannabis use | 5.26 | 4.64 to 5.96 | <0.001 |
Smoking | 1.13 | 1.003 to 1.27 | 0.04 |
Anxiety | 3.99 | 3.59 to 4.43 | <0.001 |
Stress Reaction | 3.60 | 2.06 to 6.29 | <0.001 |
Post-traumatic stress disorder | 0.51 | 0.39 to 0.67 | 0.001 |
Bipolar Disorder | 0.39 | 0.32 to 0.48 | <0.001 |
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Thavamani, A.; Umapathi, K.K.; Khatana, J.; Bhandari, S.; Kovacic, K.; Venkatesan, T. Cyclic Vomiting Syndrome-Related Hospitalizations Trends, Comorbidities & Health Care Costs in Children: A Population Based Study. Children 2022, 9, 55. https://doi.org/10.3390/children9010055
Thavamani A, Umapathi KK, Khatana J, Bhandari S, Kovacic K, Venkatesan T. Cyclic Vomiting Syndrome-Related Hospitalizations Trends, Comorbidities & Health Care Costs in Children: A Population Based Study. Children. 2022; 9(1):55. https://doi.org/10.3390/children9010055
Chicago/Turabian StyleThavamani, Aravind, Krishna Kishore Umapathi, Jasmine Khatana, Sanjay Bhandari, Katja Kovacic, and Thangam Venkatesan. 2022. "Cyclic Vomiting Syndrome-Related Hospitalizations Trends, Comorbidities & Health Care Costs in Children: A Population Based Study" Children 9, no. 1: 55. https://doi.org/10.3390/children9010055