Pediatric traumatic amputations and hospital resource utilization in the US, 2003

Purpose: To calculate national estimates of traumatic amputation-related hospitalization and use of health care resources among patients ≤17 years, and to explore the effects of sociodemographics, health care system factors and injury severity on hospital charges and lengths of stay (LOSs) in the United States.

Methods: The 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) was used to calculate national estimates of amputation-associated hospitalizations, rates, resource use, Injury Severity Scores (ISS), and demographics. Potentially significant covariate associations were studied using hospital charges and LOS.

Results: In 2003, 1,140 cases of traumatic amputations among children ≤17 years old resulted in more than $34.3 million (SD=$3.4 million) in inpatient charges and 6,233 days (SD=560) of hospitalization in the US. Mean (SD) hospital charges and LOS were $31,129 ($71,995) and 5.5 (11.5) days, respectively. The mean (SD) ISS was 5.5 (6.1). Traumatic amputations of the leg incurred the highest mean hospital charges ($120,275), longest mean LOS (18.5 days) and highest mean ISS (12.7). Older children (ages 15-17) experienced a higher hospitalization rate per 100,000 population (2.33) than other age groups (1.69 for ages <1-4, 1.13 for ages 5-9, and 1.33 for ages 10-14). Experiencing a traumatic amputation due to a motor vehicle crash and longer LOS were significantly associated with higher total charges. Urban hospital location, being female, and higher injury severity were significantly associated with longer LOS.

Conclusions: Pediatric traumatic amputations contribute substantially to the health resource burden in the US, resulting in $34 million in inpatient charges annually.