Congenital Anomalies and Resource Utilization in Neonates Infected With Herpes Simplex Virus

Sex Transm Dis. 2009 Nov;36(11):680-5. doi: 10.1097/OLQ.0b013e3181aaf54f.

Abstract

Background: Neonatal herpes simplex virus (HSV) infection, while uncommon, is associated with substantial morbidity and mortality. However, there is little nationally representative data describing resource utilization.

Methods: This retrospective cohort study was conducted using the Pediatric Health Information System, an administrative database that contains discharge diagnosis and resource utilization data from 35 free-standing children's hospitals. Patients <or=60 days of age with a primary discharge diagnosis of HSV were study eligible if they received intravenous acyclovir and were discharged between January 1, 2003 and December 31, 2005.

Results: There were 406 patients with HSV. The median age was 16 days (interquartile range: 8-31 days); 52% of patients were female. Congenital heart disease, the most common congenital anomaly, occurred in 10% of patients. The median length of stay was 15 days; 21 (5%) patients died. HSV was associated with substantial resource utilization. The median hospital charge was $37,431 (interquartile range: $14,667-$74,559) per infant. The presence of congenital heart disease independently increased the hospital length of stay by 93% (adjusted LOS ratio: 1.93; 95% CI: 1.5-2.5).

Conclusions: HSV infection in neonates and young infants was associated with substantial resource utilization. The presence of an underlying congenital cardiac anomaly was associated with a significantly longer length of stay and higher hospital charges.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acyclovir / economics
  • Acyclovir / therapeutic use
  • Antiviral Agents / therapeutic use
  • Cohort Studies
  • Female
  • Health Resources / statistics & numerical data*
  • Heart Defects, Congenital / complications*
  • Herpes Simplex / complications*
  • Herpes Simplex / drug therapy*
  • Herpes Simplex / economics
  • Hospital Charges*
  • Humans
  • Infant
  • Infant, Newborn
  • Information Systems
  • Length of Stay*
  • Male
  • Pennsylvania / epidemiology
  • Retrospective Studies
  • Simplexvirus*

Substances

  • Antiviral Agents
  • Acyclovir