Published in:
Open Access 01-12-2017 | Correction
Correction to: Hospital discharges for fever and neutropenia in pediatric cancer patients: United States, 2009
Published in: BMC Cancer | Issue 1/2017
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After publication of the original article [1] the authors found that the following errors had occurred:
1.
There was an error in the ICD-9-CM coding present in the manuscript. Specifically, the variable for “decreased white blood cell count” was incorrectly coded. The “decreased white blood cell count” variable accounted for a small proportion of the total population studied. There were only 11 fewer patients in the final fever and neutropenia population.
Reanalyzing the data using the corrected ICD-9-CM codes yielded nearly identical results to those found in the original manuscript. None of the slight changes to odds ratios and p-values changed the inferences of the results, except for overall charges for short length of stay (3 days or less) discharges decreased from $65.5 to $60.5 million US dollars.
2.
The original manuscript includes an incorrect version of Table 4. The estimates presented in the results section of the manuscript are accurate, as is the discussion of these results throughout the text and abstract. The revised Table 4 is included in this Correction and has also been adjusted to take into account the above-mentioned error in coding.
Table 1
Characteristics of Discharges for Non-Transferred Pediatric Cancer Patients: Overall and for Fever and Neutropenia (FN) Discharges – United States, 2009
|
Proportion of Overall Pediatric Cancer Discharges
|
Proportion of Pediatric FN Discharges
|
|
|---|---|---|
|
% (95% CI)
|
||
|
Patient Characteristics
|
||
|
Gender
|
||
|
Female
|
45.0 (44.2–45.8)
|
46.5 (45.0–48.0)
|
|
Age
|
||
|
0–4 years
|
28.9 (27.8–30.0)
|
36.7 (34.6–38.8)
|
|
5–9 years
|
22.0 (21.2–22.7)
|
27.9 (26.6–29.3)
|
|
10–14 years
|
21.3 (20.6–22.0)
|
18.2 (17.0–19.6)
|
|
15–19 years
|
27.8 (26.6–29.1)
|
17.1 (15.7–18.7)
|
|
Race/Ethnicity
|
||
|
White
|
48.4 (44.2–52.7)
|
55.7 (50.5–60.8)
|
|
Black
|
9.7 (8.4–11.2)
|
7.1 (5.7–8.7)
|
|
Hispanic
|
21.2 (17.7–25.3)
|
17.1 (13.6–21.3)
|
|
Asian/Pacific Islander
|
7.9 (6.7–9.4)
|
7.5 (6.0–9.4)
|
|
Primary Payer
|
||
|
Public
|
39.2 (36.7–41.9)
|
37.1 (34.2–40.0)
|
|
Private
|
53.4 (50.9–55.9)
|
57.3 (54.1–60.4)
|
|
Self-pay
|
2.2 (1.5–3.1)
|
2.4 (1.4–4.0)
|
|
Other
|
5.2 (3.9–6.9)
|
3.2 (2.5–4.2)
|
|
Mean Household Income per Zip Code
|
||
|
1st quartile
|
24.8 (22.5–27.3)
|
24.1 (20.7–27.8)
|
|
2nd quartile
|
25.3 (50.9–55.9)
|
25.1 (23.0–27.2)
|
|
3rd quartile
|
25.3 (1.5–3.1)
|
24.3 (22.2–26.6)
|
|
4th quartile
|
24.6 (21.8–27.6)
|
26.5 (22.6–30.8)
|
|
Type of Cancer
|
||
|
ALL
|
24.6 (23.5–25.8)
|
44.3 (41.6–47.0)
|
|
Bone Cancer
|
12.8 (12.0–13.6)
|
10.4 (9.1–12.0)
|
|
Central Nervous System Tumor
|
9.6 (8.8–10.4)
|
6.2 (5.1–7.6)
|
|
AML
|
5.9 (5.5–6.3)
|
7.4 (5.9–9.1)
|
|
Soft Tissue Sarcoma
|
5.1 (4.7–5.6)
|
4.6 (3.9–5.4)
|
|
Neuroblastoma
|
4.5 (3.9–5.1)
|
4.7 (3.7–6.0)
|
|
Hodgkin Lymphoma
|
3.2 (2.9–3.5)
|
2.9 (2.5–3.4)
|
|
Wilms Tumor
|
2.7 (2.5–3.0)
|
3.0 (2.5–3.4)
|
|
Non-Hodgkin Lymphoma
|
2.6 (2.3–2.9)
|
3.6 (3.1–4.3)
|
|
Ovarian or Testicular Tumor
|
1.7 (1.5–1.9)
|
0.7 (0.5–1.0)
|
|
Hospital Characteristics
|
||
|
Hospital Location-Teaching Status
|
||
|
Rural
|
1.7 (1.0–2.8)
|
1.6 (0.7–3.3)
|
|
Urban, non-teaching
|
9.9 (7.0–13.8)
|
7.2 (4.4–11.6)
|
|
Urban, teaching
|
88.4 (84.4–91.5)
|
91.2 (86.7–94.3)
|
|
Hospital Region
|
||
|
Northeast
|
16.3 (11.2–23.0)
|
20.7 (13.6–30.2)
|
|
Midwest
|
21.5 (15.7–28.8)
|
26.0 (18.0–36.0)
|
|
South
|
36.3 (28.6–44.8)
|
40.2 (29.7–51.8)
|
|
West
|
25.9 (18.8–34.4)
|
13.1 (7.4–22.2)
|
Table 2
Comparison of Proportion of Infectious Diagnoses by LOS Category Among Pediatric Cancer FN Discharges
|
Overall
|
LOS Category
|
|||||
|---|---|---|---|---|---|---|
|
“Short LOS” ≤3 days
|
4–7 days
|
8–14 days
|
15–30 days
|
31+ days
|
||
|
Proportion (%)
|
||||||
|
Proportion of FN DCs
|
41
|
33
|
16
|
7
|
3
|
|
|
No Infection Identified
|
75.9
|
82.7
|
77.3
|
66.9
|
62.8
|
44.4
|
|
Type of Infection
|
||||||
|
Upper Respiratory Infection
|
5.4
|
6.0
|
5.6
|
4.0
|
4.1
|
5.3
|
|
Acute Otitis Media
|
2.9
|
3.7
|
2.3
|
2.3
|
2.2
|
3.3
|
|
Bloodstream Infection
|
10.4
|
3.1
|
9.5
|
20.8
|
23.8
|
35.6
|
|
Viral Infection
|
2.3
|
3.1
|
2.3
|
1.6
|
0.2
|
0
|
|
Urinary Tract Infection
|
1.9
|
1.1
|
2.3
|
2.2
|
2.6
|
4.6
|
|
Pneumonia
|
1.1
|
0.3
|
0.6
|
2.3
|
4.1
|
6.8
|
Table 3
Mean Charges for Pediatric Cancer Fever and Neutropenia Discharges: Overall and by Length of Stay Category - United States, 2009
|
Mean Charges
|
Total Charges
|
|
|---|---|---|
|
Overall
|
$46,938
|
$528,052,500
|
|
Length of Stay Category
|
||
|
≤ 3 days – “Short LOS”
|
$13,098
|
$60,538,956
|
|
4–7 days
|
$30,092
|
$112,935,276
|
|
8–14 days
|
$65,313
|
$115,604,010
|
|
15–30 days
|
$149,780
|
$115,031,040
|
|
> 30 days
|
$371,506
|
$124,826,016
|
Table 4
Multivariate Logistic Regression to Evaluate Factors Associated with a “Short LOS” (≤3 days) Among Pediatric Cancer Fever and Neutropenia Discharges
|
Factors
|
Adjusted Odds Ratio (OR)
|
95% CI
|
p-value
|
|---|---|---|---|
|
Gender
|
|||
|
Female
|
1.00
|
0.88–1.12
|
0.943
|
|
Age
|
|||
|
15–19 years
|
Ref
|
||
|
10–14 years
|
0.98
|
0.78–1.23
|
0.873
|
|
5–9 years
|
1.23
|
0.98–1.54
|
0.071
|
|
0–4 years
|
1.15
|
0.95–1.40
|
0.148
|
|
Primary Payer
|
|||
|
Public
|
Ref
|
||
|
Private
|
1.14
|
0.99–1.31
|
0.065
|
|
Self-pay
|
1.18
|
0.71–1.95
|
0.533
|
|
Other
|
1.30
|
0.93–1.82
|
0.125
|
|
Median Household Income per Zip Code
|
|||
|
1st quartile
|
Ref
|
||
|
2nd quartile
|
1.09
|
0.89–1.33
|
0.390
|
|
3rd quartile
|
1.09
|
0.91–1.31
|
0.334
|
|
4th quartile
|
1.11
|
0.9–1.37
|
0.316
|
|
Hospital Location-Teaching Status
|
|||
|
Urban, teaching
|
Ref
|
||
|
Urban, non-teaching
|
0.76
|
0.55–1.06
|
0.110
|
|
Rural
|
1.23
|
0.80–1.91
|
0.346
|
|
Hospital Region
|
|||
|
Northeast
|
Ref
|
||
|
Midwest
|
1.66
|
1.23–2.24
|
0.001
|
|
South
|
1.25
|
0.99–1.57
|
0.062
|
|
West
|
1.54
|
1.11–2.15
|
0.01
|
|
Type of Infection
|
|||
|
Upper Respiratory Infection
|
1.12
|
0.90–1.40
|
0.294
|
|
Acute Otitis Media
|
1.39
|
1.03–1.87
|
0.031
|
|
Bloodstream Infection
|
0.17
|
0.14–0.22
|
<0.001
|
|
Viral Infection
|
1.63
|
1.18–2.25
|
0.003
|
|
Urinary Tract Infection
|
0.50
|
0.32–0.76
|
0.001
|
|
Pneumonia
|
0.28
|
0.13–0.60
|
0.001
|
|
Type of Cancer
|
|||
|
ALL
|
0.94
|
0.77–1.13
|
0.492
|
|
Bone Cancer
|
1.24
|
0.98–1.58
|
0.075
|
|
Central Nervous System Tumor
|
1.06
|
0.81–1.39
|
0.651
|
|
AML
|
0.35
|
0.25–0.49
|
<0.001
|
|
Soft Tissue Sarcoma
|
1.46
|
1.05–2.04
|
0.024
|
|
Neuroblastoma
|
0.65
|
0.46–0.93
|
0.019
|
|
Hodgkin Lymphoma
|
2.32
|
1.61–3.35
|
<0.001
|
|
Wilms Tumor
|
1.26
|
0.84–1.89
|
0.260
|
|
Non-Hodgkin Lymphoma
|
0.73
|
0.52–1.01
|
0.061
|
|
Ovarian or Testicular Tumor
|
1.76
|
1.05–2.95
|
0.031
|