Espahbodi M, et al. - The variation brought about by propranolol on the resource utilization were explored in this trial, in the management trends of infantile hemangioma (IH). A rise was observed in the total admissions and hospital charges in the study cohort, from 2003 to 2012. A substantial decrease was disclosed in the percentage of patients undergoing tracheostomy, tracheoscopy and laryngoscopy with biopsy, and skin lesion excision, in 2012 compared to 2003. This data pointed towards a potential impact of propranolol. In order to scrutinize these changes more closely, additional analyses were required.

Methods

• A search was carried out of the Kids' Inpatient Database (KID) in 2003, 2006, 2009, and 2012.
• The intent was to identify the ICD-9 codes for IH in children under age three.
• An assessment was conducted of the number of patients undergoing the following procedures of interest: Tracheostomy, tracheoscopy and laryngoscopy with biopsy, and excision of skin lesion.
• Data analysis was conducted with regard to the demographics and details on the admission.
• Trends were identified.
• Weighted statistical analyses were performed with SAS 9.4.

Results

• A marked rise was noted in the number of qualified admissions over the years (9,271 in 2003-12029 in 2012, OR 1.042 per year increase, p < 0.001).
• The range of mean age at admission was 26 to 28 days but ther was no variation over time (p=0.54).
• A substantial decrease was noted in the percentage undergoing tracheostomy from 1.05% in 2003 to 0.27% in 2012 (p=0.0055), and the percentage undergoing tracheoscopy and laryngoscopy with biopsy prominently decreased from 7.29% in 2003 to 4.20% in 2012 (p=0.011) among those with IH of unspecified or other sites.
• Additionally, a notable decrease was disclosed in the percentage undergoing skin lesion excision from 1.87% in 2003 to 1.03%, in 2012 (p=0.0038) among those with IH of skin and subcutaneous tissue.
• The yielded data pointed towards a potential impact of propranolol.
• A rise was determined in the total hospital charges from a mean of $17,838 in 2003 to an adjusted mean of $41,306 in 2012 (p < 0.0001), after adjusting for inflation.