MP64-02 INCREASED RISK OF REPEAT INFECTIONS PRIOR TO VESICO-URETERAL REFLUX DIAGNOSIS SINCE THE 2011 AAP GUIDELINES

You have accessJournal of UrologyPediatrics: Urinary Tract Infection & Vesicoureteral Reflux (MP64)1 Apr 2019MP64-02 INCREASED RISK OF REPEAT INFECTIONS PRIOR TO VESICO-URETERAL REFLUX DIAGNOSIS SINCE THE 2011 AAP GUIDELINES Ted Lee*, Lauren Corona, Kathryn Marchetti, Bloom David, Vesna Ivancic, Kate Kraft, John Park, Bryan Sack, Courtney Streur, and Julian Wan Ted Lee*Ted Lee* More articles by this author , Lauren CoronaLauren Corona More articles by this author , Kathryn MarchettiKathryn Marchetti More articles by this author , Bloom DavidBloom David More articles by this author , Vesna IvancicVesna Ivancic More articles by this author , Kate KraftKate Kraft More articles by this author , John ParkJohn Park More articles by this author , Bryan SackBryan Sack More articles by this author , Courtney StreurCourtney Streur More articles by this author , and Julian WanJulian Wan More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556894.12764.e5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: We have previously reported a decreased incidence and delay in vesico-ureteral reflux (VUR) diagnosis since the 2011 American Academy of Pediatrics (AAP) guidelines were released. We hypothesized that delay in diagnosis has led to an increased risk of repeat urinary tract infection (UTI) or pyelonephritis episodes prior to the diagnosis of underlying VUR. METHODS: We performed our analysis using CliniformaticsTM Data Mart (Optuminsight, Eden Prairie, MN) administrative claims data from January 2007 to December 2016. Children 0 to 10 years of age who were diagnosed with VUR were included. All emergency department encounters with UTI or pyelonephritis diagnosis codes prior to initial VUR diagnosis were recorded. Pearson's chi-squared test was used to test for an association between multiple UTI or pyelonephritis related emergency department encounters and VUR diagnosis before or after the release of the 2011 AAP guidelines (September 2011). RESULTS: A total of 1,314 patients with underlying VUR presented to the emergency department prior to their diagnosis. In the pre-AAP cohort, 822 patients presented to the emergency department, and in the post-AAP cohort 428 patients presented to the emergency department. Children diagnosed with VUR after the 2011 AAP guidelines were more likely to present with multiple UTI or pyelonephritis related emergency department encounters prior to VUR diagnosis (p = 0.002). Of the post-AAP cohort, 13.0% of the post-AAP cohort had multiple UTI or pyelonephritis related emergency department visits compared to 7.8% of the pre-AAP cohort (OR = 1.77, 95% CI 1.21 - 2.60). Children 0 - 2 years of age diagnosed with VUR after the 2011 AAP guidelines were also more likely to present with multiple emergency department visits prior to diagnosis (p = 0.02; 6.8% versus 3.0% (OR = 2.35, 95% CI 1.08 - 5.18)). CONCLUSIONS: Children with underlying VUR may be at higher risk of multiple UTI or pyelonephritis emergency room episodes prior to initial diagnosis since the release of the 2011 AAP guidelines. This is a consequence of delayed diagnosis in children with underlying VUR. Source of Funding: none Ann Arbor, MI© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e941-e941 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ted Lee* More articles by this author Lauren Corona More articles by this author Kathryn Marchetti More articles by this author Bloom David More articles by this author Vesna Ivancic More articles by this author Kate Kraft More articles by this author John Park More articles by this author Bryan Sack More articles by this author Courtney Streur More articles by this author Julian Wan More articles by this author Expand All Advertisement PDF downloadLoading ...