Epidemiology, Complications, and Cost of Hospitalization in Children With Laboratory-Confirmed Influenza Infection

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Abstract
BACKGROUND. Influenza causes significant morbidity among children. Previous studies used indirect case ascertainment methods with little cost data. We sought to measure the burden of laboratory-confirmed influenza from hospitalized children. METHODS. We conducted a retrospective cohort study during 3 viral seasons at Primary Children's Medical Center (Salt Lake City, UT). Children ≤18 years of age who were hospitalized with laboratory-confirmed influenza infection were included. Outcomes included hospitalization rates, complications including intensive care unit stays, mechanical ventilation, length of stay, and total hospital costs. RESULTS. A total of 325 children had hospitalizations attributable to influenza over 3 viral seasons: 28% 2 years of age; 37% had high-risk medical conditions. Population-based rates of hospitalization for Salt Lake County residents ranged from 6.3 to 252.7 per 100000 children. The highest rates were in children younger than 6 months, and rates decreased with increasing age. Forty-nine (15%) children had an ICU stay; 27 required mechanical ventilation, and half of these patients were >2 years of age. Total hospital cost for the cohort was $2 million; 55% was accounted for by children >2 years of age. Length of stay and total hospital costs were significantly higher in all children >2 years of age compared with children 2 years of age.