Patterns of Inpatient Care for Newly Diagnosed Immune Thrombocytopenia in US Children’s Hospitals

• DOI: 10.1542/peds.2012-2021
• Publication Date: 2013-04-09T00:47:49Z
• Authors: Courtney Kime; Jennifer Klima; Melissa J. Rose; Sarah H. O’Brien
• Keywords: Male; Inpatients; Adolescent; Databases, Factual; Cost-Benefit Analysis; Immunoglobulins, Intravenous; Infant; Length of Stay; Hospitals, Pediatric; Patient Discharge; 3. Good health; Cohort Studies; 03 medical and health sciences; Patient Admission; 0302 clinical medicine; Child, Preschool; Humans; Female; Hospital Mortality; Patient Care; Hospital Costs; Child; Follow-Up Studies

Although recent evidence-based guidelines for the management of immune thrombocytopenia (ITP) recommend a conservative, observation-based approach majority patients with newly diagnosed pediatric ITP, current practice patterns are unknown. This study used Pediatric Health Information System database to examine inpatient care in ITP freestanding US children's hospitals and geographic differences care.Data were extracted from all admissions aged 1 18 years discharged between January 2008 December 2010. Clinical data obtained included age, gender, length stay, diagnoses, medications, discharge status.We identified 2314 unique meeting diagnosis ITP. Noncutaneous bleeding occurred 12% (intracranial hemorrhage 0.6%), epistaxis most commonly reported symptom. Ninety percent hospitalized received ITP-directed therapy, intravenous immunoglobulin G therapy (78% patients). We significant variation by region treatment strategies, hospital charges, likelihood readmission.A substantial number children continue be receive although these do not have clinical events during admission. By using results as backdrop, future studies will able identify if admissions, costs care, variability decrease dissemination implementation recently published guidelines.