The public health impact of pediatric caustic ingestion injuries

Objective: To determine the current public health burden of injuries due to caustic ingestion in children. Design: The 2009 Kids' Inpatient Database provides data on a sample of all pediatric hospital discharges in the United States during that year. Children with caustic ingestion injuries requiring hospitalization were identified by corresponding codes from the International Classification of Diseases, Ninth Revision. Database analysis generated national estimates of summary statistics. Setting: A national database. Patients: Representative sample of all hospital discharge data on patients 18 years or younger. Main Outcome Measures: Public health burden related to caustic injury, including potential factors related to admission outcome, the necessity of a procedure during the admission, admission length of stay, and total charges for the admission. Results: We estimated the prevalence of pediatric caustic ingestion injuries requiring hospitalization in the United States in 2009 to be 807 (95% CI, 731-882) children. The annual economic burden was estimated at $22 900 000 (95% CI, $15 400 000-$30 400 000) in total hospital charges. The mean charge per patient was estimated at $28 860 (95% CI, $19 799-$37 922) with a median of $9848. The mean length of admission was 4.13 (95% CI, 3.22-5.03) days with a median of 2 days. Among the 807 patients, 45.3% underwent esophagoscopy, and those admitted to teaching hospitals were more likely to undergo a procedure during their stay (P = .02). Logistic regression models suggested significant median income (P < .001) and sex (P < .001) variations. Conclusions: The current public health burden of pediatric caustic ingestion injuries may be less than commonly cited. This finding supports the notion that legislative efforts have been successful. Despite these successes, these injuries continue to impose a significant burden on health care resources.