Journal Article

Respiratory syncytial virus hospitalization risk in the second year of life by specific congenital heart disease diagnoses

Friedman, Deborah, Jiang, Xiaohui, Ambrose, Christopher S., Wong, Pierre C., Fryzek, Jon, Bloomfield, Adam

2017

Overview

Children with hemodynamically significant congenital heart disease (CHD) are at elevated risk of morbidity and mortality due to respiratory syncytial virus (RSV) disease compared to their healthy peers. Previous studies have demonstrated lower RSV hospitalization risk among all children with CHD at 12-23 months of age versus 0-11 months of age. However, RSV hospitalization risk at 12-23 months of age by specific CHD diagnosis has not been characterized. Both case-control and cohort studies were conducted using data from the US National Inpatient Sample from 1997 to 2013 to characterize relative risk of RSV hospitalization among children 12-23 months of age with CHD. Related CHD diagnoses were combined for analysis. Hospitalizations for RSV and unspecified bronchiolitis were described by length of stay, mechanical ventilation use, mortality, and total charges. Over the 17-year period, 1,168,886 live birth hospitalizations with CHD were identified. Multiple specific CHD conditions had an elevated odds ratio or relative risk of RSV hospitalization. Mean total RSV hospitalization charges were significantly higher among children with CHD relative to those without CHD ($19,650 vs $7,939 in 2015 dollars) for this period. Compared to children without CHD, children with Ebstein's anomaly, transposition of the great arteries, aortic stenosis, heterotaxia, and aortic arch anomalies had 367-, 344-, 203-, 117- and 47-fold increased risk of inpatient RSV mortality, respectively. Unspecified bronchiolitis hospitalization odds and relative risk across CHD diagnoses were similar to those observed with RSV hospitalization; however, unspecified bronchiolitis hospitalizations were associated with shorter mean days of stay and less frequently associated with mechanical ventilation or mortality. Among children with more severe CHD diagnoses, RSV disease remains an important health risk through the second year of life. These data can help inform decisions regarding interventions to protect children with CHD from severe RSV disease during their second year of life.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Age / Analysis / Aorta / Aortic arch / Aortic stenosis / Arteries / Biology and Life Sciences / Bronchopneumonia / Cardiovascular disease / Cardiovascular diseases / Care and treatment / Children / Complications and side effects / Congenital diseases / Congenital heart defects / Coronary artery disease / Databases, Factual / Female / Health risks / Heart / Heart Defects, Congenital - complications / Heart Defects, Congenital - diagnosis / Heart Defects, Congenital - virology / Heart diseases / Hospital admission and discharge / Hospitalization / Hospitals / Humans / Infant / Infections / Infectious diseases / Inpatients / Intensive care / Male / Mechanical ventilation / Medical diagnosis / Medicine and Health Sciences / Morbidity / Mortality / Patient Admission / Pediatrics / People and Places / Quality / Respiratory syncytial virus / Respiratory syncytial virus infection / Respiratory Syncytial Virus Infections - complications / Respiratory Syncytial Virus Infections - therapy / Respiratory Syncytial Virus, Human - physiology / Risk / Risk Assessment / Risk factors / Stenosis / Transposition / Trends / Ventilation / Viruses