Friedman et al: A 2016 study of RSV hospitalization, mechanical ventilation, and inpatient mortality among children with specific CHD diagnoses during their second year of life.1

This observational study that examined 17 years of data identified 4,813 RSV hospitalizations among children 12-23 months of age with CHD

Study Design

This retrospective study utilized cohort and case-control approaches using data from the 1997-2013 National Inpatient Sample database to estimate RSV hospitalization rates at 12-23 months of age among children diagnosed with various types of CHD.

Study Limitations

Data from the NIS database do not enable identification of which patients had received immunoprophylaxis. Selective use of immunoprophylaxis during many of the years studied may have reduced the overall incidence of RSV hospitalizations among the CHD population. It is likely that not all high risk children 12-23 months of age with CHD received immunoprophylaxis. No patient-level data were available on the status of surgical correction for the hospitalized children.

Data Source

1997-2013 National Inpatient Sample database

Patient Selection Criteria

Children with and without CHD ages 12-23 months of age

Increased Risk of Mechanical Ventilation and Inpatient Mortality

  • Among the top 20 CHD diagnostic subgroups, the use of mechanical ventilation was required in 4.4% to 33.9% of children
  • Mechanical ventilation use was highest in children with congestive heart failure (33.9%), transposition of great vessels (30.7%), and cardiomyopathy (29.3%)
Graph showing number of RSV-related hospitalizations among commercially-insured infants by gestational age and RSV season (2013-2014 vs. 2014-2015).
Graph showing increased risk of mechanical ventilation in children with congestive heart failure 
  • Inpatient mortality was highest in the following CHD diagnostic subtypes: transposition of great vessels (10.2%), congestive heart failure (9.2%), and cardiomyopathy (9.2%)
Graph showing number of RSV-related hospitalizations among commercially-insured infants by gestational age and RSV season (2010-2014 vs 2014-2015).
Graph showing increased risk of inpatient mortality in children with Congenital Heart Disease (CHD) 

Summary

Friedman et al conclusions:

  • In the second year of life, the risk of RSV hospitalization among children with CHD was higher than that of healthy full-term infants
  • Children with certain types of CHD have high rates of mechanical ventilation and inpatient mortality

Reference

  1. Friedman D, Fryzek J, Jiang X, et al. Respiratory syncytial virus hospitalization risk in the second year of life by specific congenital heart disease diagnoses. PLoS ONE. 12(3): e0172512. doi:10.1371/ journal.pone.0172512.