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Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children

While respiratory virus PCR panel (RVPP) is more expensive than shell vial (SV) cell culture, it has been shown to reduce unnecessary diagnostic procedures, decrease the inappropriate use of antimicrobials, and shorten the hospital length of stay (LOS). We therefore hypothesized that, for hospitaliz...

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Autores principales: Iroh Tam, Pui-Ying, Zhang, Lei, Cohen, Zohara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296664/
https://www.ncbi.nlm.nih.gov/pubmed/28067857
http://dx.doi.org/10.3390/children4010003
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author Iroh Tam, Pui-Ying
Zhang, Lei
Cohen, Zohara
author_facet Iroh Tam, Pui-Ying
Zhang, Lei
Cohen, Zohara
author_sort Iroh Tam, Pui-Ying
collection PubMed
description While respiratory virus PCR panel (RVPP) is more expensive than shell vial (SV) cell culture, it has been shown to reduce unnecessary diagnostic procedures, decrease the inappropriate use of antimicrobials, and shorten the hospital length of stay (LOS). We therefore hypothesized that, for hospitalized children, RVPP would be associated with improved clinical outcomes but higher hospital charges than SV cell culture. We performed a retrospective cohort study of hospitalized children. Multivariate analysis was performed, and p-values were calculated. Respiratory virus testing was collected in a total of 1625 inpatient encounters, of which 156 were tested positive by RVPP (57.7%) and 112 were tested positive by SV (11.1%, p < 0.05). Excluding human rhinovirus (HRV) and human metapneumovirus (hMPV) from the analysis, patients with a positive test from SV had more comorbidities (p = 0.04) and higher mortality (p = 0.008). Patients with a positive test from RVPP had shorter LOS (p = 0.0503). Hospital charges for patients with a positive test from RVPP were lower, but not significantly so. When a multivariate analysis was performed, there were no statistically significant differences in comorbidities, mortality, LOS, or median hospital charges between those patients with a positive SV and those with a positive RVPP. Although testing with RVPP significantly increased the detection of respiratory viruses, clinical outcomes remained comparable to those tested with SV, however RVPP was found to not be associated with higher long-term hospital costs.
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spelling pubmed-52966642017-02-10 Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children Iroh Tam, Pui-Ying Zhang, Lei Cohen, Zohara Children (Basel) Article While respiratory virus PCR panel (RVPP) is more expensive than shell vial (SV) cell culture, it has been shown to reduce unnecessary diagnostic procedures, decrease the inappropriate use of antimicrobials, and shorten the hospital length of stay (LOS). We therefore hypothesized that, for hospitalized children, RVPP would be associated with improved clinical outcomes but higher hospital charges than SV cell culture. We performed a retrospective cohort study of hospitalized children. Multivariate analysis was performed, and p-values were calculated. Respiratory virus testing was collected in a total of 1625 inpatient encounters, of which 156 were tested positive by RVPP (57.7%) and 112 were tested positive by SV (11.1%, p < 0.05). Excluding human rhinovirus (HRV) and human metapneumovirus (hMPV) from the analysis, patients with a positive test from SV had more comorbidities (p = 0.04) and higher mortality (p = 0.008). Patients with a positive test from RVPP had shorter LOS (p = 0.0503). Hospital charges for patients with a positive test from RVPP were lower, but not significantly so. When a multivariate analysis was performed, there were no statistically significant differences in comorbidities, mortality, LOS, or median hospital charges between those patients with a positive SV and those with a positive RVPP. Although testing with RVPP significantly increased the detection of respiratory viruses, clinical outcomes remained comparable to those tested with SV, however RVPP was found to not be associated with higher long-term hospital costs. MDPI 2017-01-07 /pmc/articles/PMC5296664/ /pubmed/28067857 http://dx.doi.org/10.3390/children4010003 Text en © 2017 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Iroh Tam, Pui-Ying
Zhang, Lei
Cohen, Zohara
Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children
title Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children
title_full Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children
title_fullStr Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children
title_full_unstemmed Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children
title_short Impact of a Transition from Respiratory Virus Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized Children
title_sort impact of a transition from respiratory virus shell vial to multiplex pcr on clinical outcomes and cost in hospitalized children
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296664/
https://www.ncbi.nlm.nih.gov/pubmed/28067857
http://dx.doi.org/10.3390/children4010003
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