Abstract 5051: Retrospective analysis of direct inpatient charges and mortality of leukemia pediatric patients with Methicillin-resistant Staphylococcus aureus, Candida, or Aspergillus infections in the United States

Abstract Objective: The purpose of this study was to assess risk factors that are associated with inpatient charges and mortality rates with Methicilin-resistant Staphylococcus aureus (MRSA), Aspergillus, and Candida in children with leukemia. We hypothesize that MRSA and opportunistic fungal infections are associated with higher inpatient charges and worse outcomes relative to those without infections. Identifying the risk factors that affect mortality and inpatient charges of these infections should add to the current knowledge of treating and preventing these infections in immune compromised patients. Methods: Retrospective cohort study using the Agency for Healthcare Research Quality's Healthcare Cost and Utilization Project 2009 KIDS database. Overall, 33,020 individual hospital visits were analyzed for pediatric leukemia patients. Results: Predictors of increased mortality were: Age (OR=1.1, SE=0.02), MRSA (OR=7.2, SE=5.2), Aspergillus (OR=6.3, SE=2.1), Candida (OR=5.7, SE=1.3), and Deyo-Charlson comorbidity scores (OR=1.7, SE=0.13). Significant predictors of increased inpatient charges were: MRSA (OR=2.2, SE=0.35), Aspergillus (OR=2.7, SE=0.25), Candida (OR=2.3, SE=0.15), Female Sex (OR=1.1, SE=0.04), Deyo-Charlson comorbidity scores (OR=1.2, SE=0.04), Urban Hospitals (OR=1.9, SE=0.24), and the Southern Region (OR=0.84, SE=0.2=07). Significant predictors of increased length of stay were similar to predictors of inpatient charges. Conclusions: Although uncommon in leukemia cases involving pediatrics or young adults, risks of higher mortality, length of stay, and inpatient charges were noted in cases involving MRSA, Aspergillus, and Candida. The burden of these illnesses requires further attention in order to improve outcomes among patients with leukemia. Citation Format: Tomas Nuño, Grant H. Skrepnek. Retrospective analysis of direct inpatient charges and mortality of leukemia pediatric patients with Methicillin-resistant Staphylococcus aureus, Candida, or Aspergillus infections in the United States. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5051. doi:10.1158/1538-7445.AM2014-5051