Abstract
Objectives:
1) Identify the current public health burden of pediatric deep neck space abscesses. 2) Determine if reports of nonsurgical management of pediatric deep neck space abscesses has resulted in a change in national practice patterns.
Methods:
The 2000 and 2009 Kids’ Inpatient Databases were used to gather data on a sample of all pediatric discharges in the United States during the years 2000 and 2009. Children diagnosed with deep neck space abscesses were identified by corresponding ICD-9 codes. Database analyses generated national estimates of summary statistics and comparison of trends over the nine-year period.
Results:
The estimated prevalence of deep neck abscesses requiring hospitalization in the United States increased from 2112 cases in 2000 (95% confidence interval [CI]:1837;2387) to 3617 in 2009 (95% CI:3263;3971). Total charges increased from $2,650,000 (95% CI:$2,030,000;$3,270,000) to $8,020,000 (95% CI:$6,870,000;$9,170,000) with a mean charge per admission increasing from $13,309 (95% CI:$10,557;$16,063) in 2000 to $22,492 (95% CI:$20,541;$24,444) in 2009. The mean length of stay trended down from 4.63 (95% CI:3.74;5.51) to 3.83 (95% CI:3.62;4.03) hospital days. The frequency of surgical management decreased from 52.4%(95% CI:0.476;0.572) to 41.4% (95% CI:0.386;0.443) of cases with parapharyngeal abscesses requiring surgical drainage more commonly than retropharyngeal abscesses.
Conclusions:
Recent reports of the increasing prevalence of pediatric deep neck space infections appear to be substantiated on a national level. As such, the public health burden has grown substantially in total charges and use. Although surgical drainage has long been considered the gold standard therapy, the past decade has seen this management strategy used in less than half of all children admitted.
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