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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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References

1. Hall, CB, Weinberg, GA, Iwane, MK, et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med 2009; 360: 588–598.Google Scholar
2. Stockman, LJ, Curns, AT, Anderson, LJ, Fischer-Langley, G. Respiratory syncytial virus-associated hospitalizations among infants and young children in the United States, 1997–2006. Pediatr Infect Dis J 2012; 31: 5–9.Google Scholar
3. MacDonald, NE, Hall, CB, Suffin, SC, Alexson, C, Harris, PJ, Manning, JA. Respiratory syncytial viral infection in infants with congenital heart disease. N Engl J Med 1982; 307: 397–400.Google Scholar
4. Hall, CB, Weinberg, GA, Blumkin, AK, et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics 2013; 132: e341–e348.CrossRefGoogle Scholar
5. Boyce, TG, Mellen, BG, Mitchel, EF, Wright, PF, Griffin, MR. Rates of hospitalization for respiratory syncytial virus infection among children in medicaid. J Pediatr 2000; 137: 865–870.Google Scholar
6. Aujard, Y, Fauroux, B. Risk factors for severe respiratory syncytial virus infection in infants. Respir Med 2002; 96: S9–S14.Google Scholar
7. American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn. Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. Pediatrics 2003; 112 (Pt 1): 1442–1446.Google Scholar
8. Feltes, TF, Cabalka, AK, Meissner, HC, et al. Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease. J Pediatr 2003; 143: 532–540; Retrieved March 8, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/14571236.Google Scholar
9. Yount, LE, Mahle, WT. Economic analysis of palivizumab in infants with congenital heart disease. Pediatrics 2004; 114: 1606–1611.Google Scholar
10. Harris, KC, Anis, AH, Crosby, MC, Cender, LM, Potts, JE, Human, DG. Economic evaluation of palivizumab in children with congenital heart disease: a Canadian perspective. Can J Cardiol, 27: 523.e11–523.e15.Google Scholar
11. Meberg, A, Bruu, A-L. Respiratory syncytial virus infections in congenital heart defects--hospitalizations and costs. Acta Paediatr 2006; 95: 404–406.Google Scholar
12. Chang, R-KR, Chen, AY. Impact of palivizumab on RSV hospitalizations for children with hemodynamically significant congenital heart disease. Pediatr Cardiol 2010; 31: 90–95.CrossRefGoogle ScholarPubMed
13. Committee on Infectious Diseases and Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 2014; 134: e620–e638.Google Scholar
14. Committee on Infectious Diseases and Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 2014; 134: 415–420.Google Scholar
15. HCUP Kids’ Inpatient Database (KID). Healthcare Cost and Utilization Project (HCUP). 1997, 2000, 2003, 2006, 2009. Agency for Healthcare Rsearch and Quality, Rockville, MD. Retrieved July 16, 2014, from www.hcup-us.ahrq.gov/kidoverview.jsp.Google Scholar
16. HCUP Clinical Classifications Software (CCS) for ICD-9-CM. Healthcare Cost and Utilization Project (HCUP). 1997, 2000, 2003, 2006, 2009. Agency for Healthcare Research and Quality, Rockville, MD. Retrieved July 16, 2014, from www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp.Google Scholar
17. United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Bridged-Race Population Estimates, United States July 1st resident population by state, county, age, sex, bridged-race, and Hispanic origin. Compiled from 1990–1999 bridged-race intercensal population estimates (released by NCHS on 7/26/2004); revised bridged-race 2000–2009 intercensal population estimates (released by NCHS on 10/26/2012); and bridged-race Vintage 2012 (2010–2012) postcensal population estimates (released by NCHS on 6/13/2013). Available on CDC WONDER On-line Database. Retrieved January 3, 2016, from http://wonder.cdc.gov/bridged-race-v2012.html.Google Scholar
18. Chu, B, Houchens, R, Elixhauser, A, Ross, D. Using the KIDS’ Inpatient Database (KID) to Estimate Trends. HCUP Methods Series Report # 2007-02 Online. January 10, 2007. US Agency for Healthcare Research and Quality. Retrieved February 9, 2015, from http://www.hcup-us.ahrq.gov/rep.Google Scholar
19. HCUP KID Trends Supplemental File. Healthcare Cost and Utilization Project (HCUP). 2009. Agency for Healthcare Research and Quality, Rockville, MD. Retrieved August 28, 2014, from www.hcup-us.ahrq.gov/db/nation/kid/kidtrends.jsp.Google Scholar
20. McGuiness, CB, Boron, ML, Saunders, B, Edelman, L, Kumar, VR, Rabon-Stith, KM. Respiratory syncytial virus surveillance in the United States, 2007–2012: results from a national surveillance system. Pediatr Infect Dis J 2014; 33: 589–594.Google Scholar
21. Simoes, EA, Sondheimer, HM, Top, FH, et al. Respiratory syncytial virus immune globulin for prophylaxis against respiratory syncytial virus disease in infants and children with congenital heart disease. The Cardiac Study Group. J Pediatr 1998; 133: 492–499.Google Scholar
22. The PREVENT Study Group. Reduction of respiratory syncytial virus hospitalization among premature infants and infants with bronchopulmonary dysplasia using respiratory syncytial virus immune globulin prophylaxis. The PREVENT Study Group. Pediatrics 1997; 99: 93–99.Google Scholar
23. The IMpact-RSV Study Group. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 1998; 102: 531–537.Google Scholar
24. Cohen, S a, Zanni, R, Cohen, A, Harrington, M, VanVeldhuisen, P, Boron, ML. Palivizumab use in subjects with congenital heart disease: results from the 2000–2004 Palivizumab Outcomes Registry. Pediatr Cardiol 2008; 29: 382–387.Google Scholar
25. Laas, E, Lelong, N, Thieulin, A-C, et al. Preterm birth and congenital heart defects: a population-based study. Pediatrics 2012; 130: e829–e837.Google Scholar
26. Navas, L, Wang, E, de Carvalho, V, Robinson, J. Improved outcome of respiratory syncytial virus infection in a high-risk hospitalized population of Canadian children. Pediatric investigators collaborative network on infections in Canada. J Pediatr 1992; 121: 348–354.Google Scholar
27. Moler, FW, Khan, AS, Meliones, JN, Custer, JR, Palmisano, J, Shope, TC. Respiratory syncytial virus morbidity and mortality estimates in congenital heart disease patients: a recent experience. Crit Care Med 1992; 20: 1406–1413.Google Scholar
28. Meissner, HC, Kimberlin, DW. RSV immunoprophylaxis: does the benefit justify the cost? Pediatrics. 2013; 132: 915–918.Google Scholar
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