Factors Associated With Resource Utilization and Coronary Artery Dilation in Refractory Kawasaki Disease (from the Pediatric Health Information System Database)

Lo, Jennifer Y.; Minich, L. LuAnn; Tani, Lloyd Y.; Wilkes, Jacob; Ding, Qian; Menon, Shaji C.

doi:10.1016/j.amjcard.2016.08.039

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…Data for this study were obtained from the PHIS, which is an administrative database that contains data from inpatient, ambulatory surgery, emergency department, and observation encounters at 52 tertiary care children's hospitals in the United States. 16,17 The PHIS database has been previously described. 3,18 This part of the study was deemed exempt by the NCH IRB; permission to use the PHIS data was granted by the Children's Hospital Association.…”

Section: Phis Cohortmentioning

confidence: 99%

Venous thromboembolism in children with central nervous system tumors: Comparison of an institutional cohort to a national administrative database

Graham

Coven

Stanek

et al. 2020

Pediatric Blood & Cancer

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Background: Central nervous system (CNS) tumors are the second most common malignancy of childhood, and published data on venous thromboembolism (VTE) rate and risk factors for these patients are outdated or incomplete. Here, we determine the cumulative incidence and risk factors for VTE in this population. Procedure: VTE diagnosis and associated clinical risk factors were abstracted and analyzed for two cohorts of children (0-21 years) diagnosed with CNS tumors between January 1, 2010 to September 30, 2018. The first study was a retrospective single institution cohort study. The initial observations were confirmed across multiple pediatric hospitals using the Pediatric Health Information System (PHIS) administrative database. Results: The single-institution cohort included 338 patients aged 3 days to 20.9 years (median age, 8.6 years); VTE developed in eight (2.4%) patients. The PHIS cohort included 17 634 patients aged from 0 to 21.9 years (median: 9.5 years); VTE developed in 354 (2.0%) patients. Univariate analysis for the single-institution cohort identified central venous catheter (CVC) placement as a risk factor for VTE (odds ratio [OR] 8.40, 95% confidence interval [CI] 1.43-49.41, P = .0186). Multivariable analysis of the PHIS dataset identified CVC placement (OR 1.97, 95% CI 1.57-2.46; P < .0001), obesity (OR 2.96, 95% CI 1.21-7.26; P = .0177), and more than one hospital admission (OR 3.54, 95% CI 2.69-4.64; P < .0001) as significant predictors of VTE. VTE diagnosis was not associated with increased mortality in either cohort. Conclusions: The VTE rate in children with CNS tumors is low (2%). CVC placement was identified as a modifiable risk factor in both cohorts.

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Section: Phis Cohortmentioning

confidence: 99%

Venous thromboembolism in children with central nervous system tumors: Comparison of an institutional cohort to a national administrative database

Graham

Coven

Stanek

et al. 2020

Pediatric Blood & Cancer

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show abstract

“…Data for this study was obtained from the Pediatric Health Information System (PHIS), an administrative database that contains data from inpatient, ambulatory surgery, emergency department, and observation encounters for 48 tertiarycare children's hospitals in the United States. 17,18 Participating centers are heterogeneous for bed number, daily census, and geographic location. Data reliability and quality are assured through a joint effort between the participating hospitals and the Children's Hospital Association.…”

Section: Data Sourcementioning

confidence: 99%

Prevalence and risk factors for venous thromboembolism in children with sickle cell disease: an administrative database study

et al. 2018

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“…This study was conducted within a single health system and may not be comparable with those in other regions. Notably previous studies have revealed variable incidences and risks of nonresponse in different racial and/or ethnic groups, [36][37][38][39] and the demographics found in our study may reflect local populations in addition to validity challenges of race and/or ethnicity data collection. Documentation of echocardiograms was not standardized, limiting the ability to use raw measurements or z scores in our model.…”

Section: Results From Each Sensitivity Analysis (Supplementalmentioning

confidence: 54%

Identifying Patients With Kawasaki Disease Safe for Early Discharge: Development of a Risk Prediction Model at a US Children’s Hospital

Hester¹,

Watson

Nickel

et al. 2019

Hospital Pediatrics

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To develop a model to predict risk of intravenous immunoglobulin (IVIg) nonresponse in patients with Kawasaki disease (KD) to assist in early discharge decision-making. METHODS: Retrospective cohort study of 430 patients 0 to 18 years old discharged from a US children's hospital January 1, 2010, through July 31, 2017 with a diagnosis of KD. IVIg nonresponse was defined as at least 1 of the following: temperature $38.0°C between 36 hours and 7 days after initial IVIg dose, receipt of a second IVIg dose after a temperature $38.0°C at least 20 hours after initial IVIg dose, or readmission within 7 days with administration of a second IVIg dose. Backward stepwise logistic regression was used to select a predictive model. RESULTS: IVIg nonresponse occurred in 19% (81 of 430) of patients. We identified a multivariate model (which included white blood cell count, hemoglobin level, platelet count, aspartate aminotransferase level, sodium level, albumin level, temperature within 6 hours of first IVIg dose, and incomplete KD) with good predictive ability (optimism-adjusted concordance index: 0.700) for IVIg nonresponse. Stratifying into 2 groups by a predictive probability cutoff of 0.10, we identified 26% of patients at low risk for IVIg nonresponse, with a sensitivity and specificity of 90% and 30%, respectively, and a negative predictive value of 93%. CONCLUSIONS: We developed a model with good predictive value for identifying risk of IVIg nonresponse in patients with KD at a US children's hospital. Patients at lower risk may be considered for early discharge by using shared decision-making. Our model may be used to inform implementation of electronic health record tools and future risk prediction research.

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Factors Associated With Resource Utilization and Coronary Artery Dilation in Refractory Kawasaki Disease (from the Pediatric Health Information System Database)

Cited by 11 publications

References 16 publications

Venous thromboembolism in children with central nervous system tumors: Comparison of an institutional cohort to a national administrative database

Venous thromboembolism in children with central nervous system tumors: Comparison of an institutional cohort to a national administrative database

Prevalence and risk factors for venous thromboembolism in children with sickle cell disease: an administrative database study

Identifying Patients With Kawasaki Disease Safe for Early Discharge: Development of a Risk Prediction Model at a US Children’s Hospital

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