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Respiratory syncytial virus hospitalisation trends in children with haemodynamically significant heart disease, 1997–2012

Published online by Cambridge University Press:  10 May 2016

Patricia Y. Chu ,
Christoph P. Hornik ,
Jennifer S. Li ,
Michael J. Campbell  and
Kevin D. Hill
Patricia Y. Chu
Affiliation:
Duke University School of Medicine, Durham, North Carolina, United States of America
Christoph P. Hornik
Affiliation:
Duke Clinical Research Institute, Durham, North Carolina, United States of America Department of Pediatrics, Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina, United States of America
Jennifer S. Li
Affiliation:
Duke Clinical Research Institute, Durham, North Carolina, United States of America Department of Pediatrics, Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina, United States of America
Michael J. Campbell
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina, United States of America
Kevin D. Hill*
Affiliation:
Duke Clinical Research Institute, Durham, North Carolina, United States of America Department of Pediatrics, Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina, United States of America
*
Correspondence to: K. D. Hill, MD, MS, Department of Pediatrics, Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, P.O. Box 17969, Durham, North Carolina 27715, United States of America. Tel: +919 668 4686; Fax: +919 668 7058; E-mail: kevin.hill@duke.edu
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Abstract

Objective

The aim of the study was to evaluate the trends in respiratory syncytial virus-related hospitalisations and associated outcomes in children with haemodynamically significant heart disease in the United States of America.

Study design

The Kids’ Inpatient Databases (1997–2012) were used to estimate the incidence of respiratory syncytial virus hospitalisation among children ⩽24 months with or without haemodynamically significant heart disease. Weighted multivariable logistic regression and chi-square tests were used to evaluate the trends over time and factors associated with hospitalisation, comparing eras before and after publication of the 2003 American Academy of Pediatrics palivizumab immunoprophylaxis guidelines. Secondary outcomes included in-hospital mortality, morbidity, length of stay, and cost.

Results

Overall, 549,265 respiratory syncytial virus-related hospitalisations were evaluated, including 2518 (0.5%) in children with haemodynamically significant heart disease. The incidence of respiratory syncytial virus hospitalisation in children with haemodynamically significant heart disease decreased by 36% when comparing pre- and post-palivizumab guideline eras versus an 8% decline in children without haemodynamically significant heart disease (p<0.001). Children with haemodynamically significant heart disease had higher rates of respiratory syncytial virus-associated mortality (4.9 versus 0.1%, p<0.001) and morbidity (31.5 versus 3.5%, p<0.001) and longer hospital length of stay (17.9 versus 3.9 days, p<0.001) compared with children without haemodynamically significant heart disease. The mean cost of respiratory syncytial virus hospitalisation in 2009 was $58,166 (95% CI:$46,017, $70,315).

Conclusions

These data provide stakeholders with a means to evaluate the cost–utility of various immunoprophylaxis strategies.

Keywords

Respiratory syncytial virusCHDpalivizumab
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 1 , January 2017 , pp. 16 - 25
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Copyright
© Cambridge University Press 2016 

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