![[ Visit Client Website ]](images/banner.gif)
Methods: The Healthcare Cost and Utilization Project Kids’ Inpatient Database, the largest all-payer pediatric inpatient database, was queried by ICD-9 code for patients from 2000-2012 with a primary diagnosis of pectus excavatum admitted primarily for its repair. Independent t-tests and Mann Whitney U tests (for equal and unequal variances, respectively) as well as regressions with variables found to be significant on univariate analysis (p<0.05) were used to relate hospital charges and complications. Dollar values are in 2015 amounts.
Results: Nine thousand thirty two patients were admitted for repair, of whom 85.0% were white and 16.5% were female. The average age was 14.17 years and the average length of stay was 4.64 days. 733 patients (8.1%) had “thorascopy” co-coded. 1,543 patients (17.1%) had at least one complication, the most common of which was iatrogenic pneumothorax (N=964, 10.7%), followed by post-operative pain (N=436, 4.8%) and pleural effusion (N=239, 2.6%). There were no injuries of the heart or lungs. Using binary logistic regression controlling for race, hospital size, hospital teaching status, age, and household income quartile, complications were more likely in large hospitals (OR 1.32, 1.15-1.53) and with increasing age (OR 1.06, 1.03-1.08). The average hospital charge was $41,015.58. Using linear regression, hospital charges were associated with western location ($13,070.78, p<0.0001), age ($429.33, p<0.0001), large hospital size ($1,121.92, p=0.18), length of stay ($8,254.58, p<0.0001), and number of procedures ($3,296.04, p<0.0001) and diagnoses ($1,750.76, p<0.0001).
Conclusions: Pectus excavatum repair is a potentially complicated procedure. Due to insensitive ICD-9 codes for types of pectus excavatum repair, conclusions cannot be drawn about the outcomes of the Nuss versus Ravitch repairs; however, this is the largest study of complications and hospital charges associated with pectus excavatum repair.