Variation in the Use of Intracranial-Pressure Monitoring and Mortality in Critically Ill Children With Meningitis in the United States

• Published in: Pediatrics (Evanston) 2006-06, Vol.117 (6), p.1893-1900
• Main Authors: Odetola, Folafoluwa O, Tilford, John M, Davis, Matthew M
• Format: Article
• Language: English
• Subjects: Adolescent; Algorithms; Care and treatment; Case studies; Child; Child, Preschool; Children & youth; Critical Illness; Diagnosis; Female; Hospital Mortality; Hospitalization; Hospitalization - statistics & numerical data; Humans; Infant; Intracranial hypertension; Intracranial Pressure; Male; Medical treatment; Meningitis; Meningitis - diagnosis; Meningitis - mortality; Meningitis - therapy; Monitoring systems; Monitoring, Physiologic - methods; Mortality; Pediatrics; Retrospective Studies; Streptococcus pneumoniae; United States
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2005-2179

Our goal was to describe patient and hospital characteristics associated with the use of intracranial pressure monitors and outcomes in critically ill children with meningitis. This was a retrospective cohort study of children 0 to 17 years of age hospitalized with meningitis and requiring mechanical ventilation using the 1997 and 2000 Kids' Inpatient Database. We generated national estimates of rates of intracranial pressure monitoring and in-hospital mortality by patient and hospital characteristics, and compared in-hospital mortality, hospital length of stay, and total charges for children who received an intracranial pressure monitor with those who did not. There were an estimated 1067 and 1170 hospitalizations nationally for childhood meningitis requiring mechanical ventilation in 1997 and 2000, respectively. Most (79%) of the hospitalizations involved infants. Overall, intracranial-pressure monitors were used in 7% of hospitalizations for meningitis, with the highest rates in children aged 5 to 17 years and lowest rates in children