JOURNAL ARTICLE
RESEARCH SUPPORT, N.I.H., EXTRAMURAL
RESEARCH SUPPORT, NON-U.S. GOV'T
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Congenital anomalies and resource utilization in neonates infected with herpes simplex virus.

BACKGROUND: Neonatal herpes simplex virus (HSV) infection, while uncommon, is associated with substantial morbidity and mortality. However, there is little nationally representative data describing resource utilization.

METHODS: This retrospective cohort study was conducted using the Pediatric Health Information System, an administrative database that contains discharge diagnosis and resource utilization data from 35 free-standing children's hospitals. Patients <or=60 days of age with a primary discharge diagnosis of HSV were study eligible if they received intravenous acyclovir and were discharged between January 1, 2003 and December 31, 2005.

RESULTS: There were 406 patients with HSV. The median age was 16 days (interquartile range: 8-31 days); 52% of patients were female. Congenital heart disease, the most common congenital anomaly, occurred in 10% of patients. The median length of stay was 15 days; 21 (5%) patients died. HSV was associated with substantial resource utilization. The median hospital charge was $37,431 (interquartile range: $14,667-$74,559) per infant. The presence of congenital heart disease independently increased the hospital length of stay by 93% (adjusted LOS ratio: 1.93; 95% CI: 1.5-2.5).

CONCLUSIONS: HSV infection in neonates and young infants was associated with substantial resource utilization. The presence of an underlying congenital cardiac anomaly was associated with a significantly longer length of stay and higher hospital charges.

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