Trends in pediatric urolithiasis: patient characteristics, associated diagnoses, and financial burden

Abstract

Background: The goal of this study was to examine national trends in hospitalization, emergency department (ED) utilization, secondary diagnoses, and charges associated with pediatric urolithiasis.

Methods: Data were evaluated from the Kids' Inpatient Database of the Healthcare Costs and Utilization Project (HCUP) database from 1997 to 2012 and the HCUP National ED Sample from 2006 to 2011.

Results: Pediatric nephrolithiasis discharges increased by 18%, while ureterolithiasis discharges decreased by 17%. Hospital charges increased by 20% when accounting for inflation, despite an overall decrease in discharges by 2.5%. Female patients and those aged 15-17 years were more commonly affected. Pediatric ED visits increased by 9%. The most common secondary diagnoses during 2003-2009 were urinary tract infections (UTI) (13%), asthma (9%), epilepsy (4%), and paralysis (4%).

Conclusions: Decreased hospitalizations and increased ED visits indicate a shift to outpatient care. Inpatient health care charges associated with pediatric urolithiasis continue to rise. Comorbidities include UTI, asthma, epilepsy, attention deficit hyperactivity disorder (ADHD), and mood disorders. Because of the significant health care burden and the increased risk to children of developing long-term sequelae there is a strong need for increased research into the mechanism of this systemic inflammatory disease and improved therapeutic targets.