Operative volume and outcomes of cerebrovascular neurosurgery in children

Bekelis, Kimon; Connolly, Ian D.; M., Huy; Choudhri, Omar

doi:10.3171/2016.5.peds16137

Cited by 17 publications

(8 citation statements)

References 25 publications

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“…Our study, utilizing the 2009 and 2012 databases, represents a comprehensive analysis with one coding scheme (ICD‐9). Several recent publications have used the KID in a similar manner to characterize other pediatric conditions …”

Section: Methodsmentioning

confidence: 99%

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Bou-Maroun

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Bou-Maroun

Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

Ferriero¹,

Fullerton²,

Bernard³

et al. 2019

Stroke

499

515

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Purpose-Much has transpired since the last scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee and were chosen to reflect the expertise of the subject matter. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. This scientific statement is based on expert consensus considerations for clinical practice. Results-Annualized pediatric stroke incidence rates, including both neonatal and later childhood stroke and both ischemic and hemorrhagic stroke, range from 3 to 25 per 100 000 children in developed countries. Newborns have the highest risk ratio: 1 in 4000 live births. Stroke is a clinical syndrome. Delays in diagnosis are common in both perinatal and childhood stroke but for different reasons. To develop new strategies for prevention and treatment, disease processes and risk factors that lead to pediatric stroke are discussed here to aid the clinician in rapid diagnosis and treatment. The many important differences that affect the pathophysiology and treatment of childhood stroke are discussed in each section. Conclusions-Here we provide updates on perinatal and childhood stroke with a focus on the subtypes, including arterial ischemic, venous thrombotic, and hemorrhagic stroke, and updates in regard to areas of childhood stroke that have not received close attention such as sickle cell disease. Each section is highlighted with considerations for clinical practice, attendant controversies, and knowledge gaps. This statement provides the practicing provider with much-needed updated information in this field. (Stroke. 2019;50:e00-e00.

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“…To account for confounding variables, e.g., region or payer type, we employed a propensity score method to compare health-care utilization metrics, accounting for systematic differences in baseline characteristics in subgroups, 22–25 as utilized by other studies of KID data. 26–29 Briefly, the propensity score was defined as the conditional probability of receiving a suspected GD diagnosis, using either the GD minimum or maximum classification, based on observed covariates and estimated from multivariate logistic regression. Covariates included race, sex, age, primary payer type, hospital region, the number of diagnoses and procedures included in the discharge, whether care was received at a freestanding children’s hospital, whether the birth was complicated, whether a major operating room procedure was performed, whether there was indication of a transfer into or out of the hospital, and whether there was evidence of emergency department services.…”

Section: Methodsmentioning

confidence: 99%

Estimating the burden and economic impact of pediatric genetic disease

Gonzaludo

Belmont

Gainullin

et al. 2019

Genetics in Medicine

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PurposeTo identify the economic impact of pediatric patients with clinical indications of genetic disease (GD) on the US health-care system.MethodsUsing the 2012 Kids’ Inpatient Database, we identified pediatric inpatient discharges with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes linked to genetic disease, including well-established genetic disorders, neurological diseases, birth defects, and other physiological or functional abnormalities with a genetic basis. Cohort characteristics and health-care utilization measures were analyzed. Discharges with a GD-associated primary diagnosis were used to estimate the minimum burden; discharges with GD-associated primary or secondary codes established the maximum burden.ResultsOf 5.85 million weighted discharges, 2.6–14% included GD-associated ICD-9-CM codes. For these discharges, mean total costs were $16,000–77,000 higher (P < 0.0001) in neonates and $12,000–17,000 higher (P < 0.0001) in pediatric patients compared with background, corresponding to significantly higher total charges and lengths of stay. Aggregate total charges for suspected GD accounted for $14 to $57 billion (11–46%) of the “national bill” for pediatric patients in 2012.ConclusionPediatric inpatients with diagnostic codes linked to genetic disease have a significant and disproportionate impact on resources and costs in the US health-care system.

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Operative volume and outcomes of cerebrovascular neurosurgery in children

Cited by 17 publications

References 25 publications

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

Estimating the burden and economic impact of pediatric genetic disease

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