Costs associated with acute kidney injury in critically Ill neonates with patent Ductus arteriosus: pediatric health information system (PHIS) analysis

Objective: Compare costs of hospitalization between critically-ill neonates with patent ductus arteriosus (PDA) who did and did not develop acute kidney injury (AKI). Study design: Using the Children’s Hospital Association’s Pediatric Health Information System (PHIS) database, we ascertained the marginal estimated total cost of hospitalization between those who did and did not develop AKI. Results: Query of 49 PHIS centers yielded 14,217 neonates with PDA, 1697 with AKI and 12,520 without AKI. Predictors of cost included AKI, birth weight, ethnicity, race, length of stay (LOS), and Feudtner Complex Chronic Conditions Classification System. LOS was the strongest predictor (AKI: median 71 days [IQR 28–130]; No AKI: 28 days [10–76]; p < 0.01). Neonates with AKI had $48,416 greater costs (95% CI: $43,804–53,227) after adjusting for these predictors (AKI: $190,063, 95% CI $183,735–196,610; No AKI: $141,647, 95% CI $139,931–143,383 l; p < 0.01). Conclusion: AKI is independently associated with increased hospital costs in critically-ill neonates with PDA.