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Volume 28, Number 2—February 2022

Epidemiology of Hospitalized Patients with Babesiosis, United States, 2010–2016

Evan M. BlochComments to Author , Jonathan R. Day, Peter J. Krause, Anne Kjemtrup, Sheila F. O’Brien, Aaron A.R. Tobian, and Ruchika Goel
Author affiliations: Johns Hopkins School of Medicine, Baltimore, Maryland, USA (E.M. Bloch, A.A.R. Tobian, R. Goel); University of Iowa Health Care, Iowa City, Iowa, USA (J.R. Day); Simmons Cancer Institute at Southern Illinois University, Springfield, Illinois, USA (J.R. Day, R. Goel); Yale School of Public Health and Yale School of Medicine, New Haven, Connecticut USA (P.J. Krause); California Department of Public Health, Sacramento, California, USA (A. Kjemtrup); Canadian Blood Services, Ottawa, Ontario, Canada (S.F. O’Brien)

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Table 3

Clinical outcomes and healthcare use in patients with babesiosis-associated hospitalizations, United States, 2010–2016*

Clinical outcome All data ICD-9 data, 2010–2015q3† ICD-10 data, 2015q4–2016†
Mortality, no. (%)
128 (1.6)
108 (1.7)
20 (1.4)
Length of stay, d
Mean (SD) 5.8 (7.3) 5.8 (10.3) 5.8 (6.5)
Median (IQR)
4 (3–7)
4 (2–6)
4 (3–7)
Total hospital charges for primary diagnosis of babesiosis‡
Mean $36,850.51 $37,236.39 $36,464.62
Aggregate national bill, USD $171,281,170 $142,911,768 $29,536,342
Mean national bill per year, USD
Transfusion and apheresis use, no. (%)
Erythrocyte transfusion 1560 (20.0) 1375 (21.6) 185 (12.8)
Platelet transfusion 208 (2.7) 183 (2.9) 25 (1.7)
Plasma transfused 88 (1.1) 78 (1.2) 10 (0.7)
Erythrocyte exchange 80 (1.0) 75 (1.2) §
Erythrocyte or plasma exchange
90 (1.2)
75 (1.2)
15 (1.0)
Complications, no. (%)
Acute renal failure 1,594 (20.4) 1,209 (19) 385 (26.6)
Respiratory failure 528 (6.8) 363 (5.7) 165 (11.4)
Acute heart failure 270 (3.5) 200 (3.1) 70 (4.8)
Disseminated intravascular coagulation 149 (1.9) 129 (2.0) 20 (1.4)

*Data are from the NIS, which offers a representative sampling of US-based hospitals. Weighted national estimates are based on data that were collected by individual states and provided to AHRQ. Total number of weighted discharges in the United States based on HCUP NIS: 37,352,013 (2010); 36,962,415 (2011); 36,484,846 (2012); 35,597,792 (2013); 35,358,818 (2014); 35,769,942 (2015); 35,675,421 (2016). Statistics based on estimates with a relative SE (SE/weighted estimate) >0.30 or with SE 0 in the nationwide statistics (NIS, Nationwide Emergency Department Sample, and Kids’ Inpatient Database) are not reliable. In 2012, the National Inpatient Sample was redesigned to optimize national estimates. The nationwide statistics in HCUPnet for years before 2012 were regenerated using new trend weights to permit longitudinal analysis. The regenerated data were posted to HCUPnet on July 2, 2014. The statistics for years before 2012 currently on HCUPnet will differ slightly from statistics obtained before July 2, 2014. Information about the NIS redesign and trend weights is available at For more information about HCUP data, see ICD-9- International Classification of Diseases, Ninth Revision; ICD-10, International Classification of Diseases, Tenth Revision; HCUP, Healthcare Cost and Utilization Project; NIS, National Inpatient Sample. †Because of the transition from ICD-9-CM to ICD-10-CM in October 2015, the data represent 2 time periods. ICD-9 data reflect 2010 through the third quarter of 2015 (2015q3), and ICD-10 data represent the fourth quarter of 2015 (2015q4) through 2016. ‡Cost data were calculated for primary diagnosis only. ICD-9 charge data were obtained solely from HCUP ( The aggregate national bill was determined by calculating the mean total charges per year multiplied by number of cases. §Statistics that are based on estimates with a relative SE (SE/weighted estimate) >0.30 or a total cell count <10 in the NIS are not reliable. These statistics are suppressed per HCUP policies.

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