Open Access

Correction to: Hospital discharges for fever and neutropenia in pediatric cancer patients: United States, 2009

  • Emily L. Mueller1, 2Email author,
  • Kelly J. Walkovich3,
  • Rajen Mody3,
  • Achamyeleh Gebremariam4 and
  • Matthew M. Davis4, 5, 6, 7
BMC Cancer201717:668

https://doi.org/10.1186/s12885-017-3654-1

Received: 25 September 2017

Accepted: 25 September 2017

Published: 2 October 2017

The original article was published in BMC Cancer 2015 15:388

Correction

After publication of the original article [1] the authors found that the following errors had occurred:
  1. 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.

    The affected values in Tables 1, 2 and 3 from the original manuscript have been amended to reflect these small changes to estimates and p-values and are included in this Correction.

     
  2. 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

Charges are adjusted to 2014 dollars using the Consumer Price Index adjustment

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

Corrected Tables

 Corrected Table 1

Corrected Table 2

Corrected Table 3

Corrected Table 4

Declarations

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Section of PediatricHematology Oncology, Department of Pediatrics, Indiana University School of Medicine
(2)
Pediatric and Adolescent Comparative Effectiveness Research, Indiana University
(3)
Division of Pediatric Hematology Oncology, Department of Pediatrics and Communicable Diseases, University of Michigan
(4)
Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan
(5)
Division of General Medicine, Department of Internal Medicine, University of Michigan
(6)
Institute for Healthcare Policy and Innovation, University of Michigan
(7)
Gerald R. Ford School of Public Policy, University of Michigan

Reference

  1. Mueller EL, Walkovich KJ, Mody R, Gebremariam A, Davis MM. Hospital discharges for fever and neutropenia in pediatric cancer patients: United States, 2009. BMC Cancer. 2015;15:388. doi:10.1186/s12885-015-1413-8.View ArticlePubMedPubMed CentralGoogle Scholar

Copyright

© The Author(s). 2017

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