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Imaging Intussusception in Children's Hospitals in the United States: Trends, Outcomes, and Costs.

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2019 May 14

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<p><strong>OBJECTIVE: </strong>To describe imaging utilization, outcomes, and cost in the management of intussusception between 2010 and 2017 in pediatric hospitals in the United States.</p>

<p><strong>METHODS: </strong>All children (under 18 years of age) with a primary diagnosis of intussusception in a large administrative database were identified. Demographics, imaging, and costs were described.</p>

<p><strong>RESULTS: </strong>There were 17,032 children (63.3% boys, 36.7% girls, mean age: 3.2 years) that had 20,655 hospital encounters for intussusception, and 88.5% were &lt;5 years of age. The average length of stay was 2.8 days (median: 1 day), with rates of intensive care unit admission, 3.7%; 90-day readmission, 10.5%; and mortality, 0.2%. The surgical rate was 19.6%, and 93.5% (n&nbsp;= 19,301) of patients underwent imaging: 87.2% (n&nbsp;= 16,822) received ultrasound, 69.1% (n&nbsp;= 13,329) had fluoroscopy, 59% (n&nbsp;= 11,380) had abdominal radiographs, and 8.8% (n&nbsp;= 1,696) had CT. The reduction success rate for fluoroscopy was 77.9%. Surgery was more common in rural patients (26.8% versus 18.7% in urban patients, P &lt; .001). Median encounter costs were $2,675 (interquartile range: $1,637-$5,465). Imaging cost represented a quarter (median $680, interquartile range: $372-1,069) of all costs. Higher costs (median) were associated with longer length of stay (&lt;3 days: $858 versus &gt;3 days: $5,342; use of CT ($4,168 versus $943 in patients without a CT), and surgery ($4,434 versus $860 without surgery).</p>

<p><strong>CONCLUSION: </strong>The management of intussusception is mainly nonsurgical, most frequently involving imaging with ultrasound and fluoroscopy, and resulting in excellent outcomes in the great majority of the cases. Despite playing a central role for diagnosis and management, imaging only represents a fraction of total cost.</p>



Alternate Title

J Am Coll Radiol


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