Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T10:37:09.508Z Has data issue: false hasContentIssue false
  • English
  • Français

Patient characteristics and incidence of childhood hospitalisation due to hypertrophic cardiomyopathy in the United States of America 2001–2014

Published online by Cambridge University Press:  25 March 2019

Rie Sakai-Bizmark ,
Eliza J. Webber ,
Emily H. Marr ,
Laurie A. Mena  and
Ruey-Kang R. Chang
Rie Sakai-Bizmark*
Affiliation:
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA Division of General Pediatrics, Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
Eliza J. Webber
Affiliation:
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
Emily H. Marr
Affiliation:
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
Laurie A. Mena
Affiliation:
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
Ruey-Kang R. Chang
Affiliation:
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA Division of Pediatric Cardiology, Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
*
Author for correspondence: R. Sakai-Bizmark, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 West Torrance Street, Torrance, CA 90502, USA. Tel: 310-222-2327; Fax: 310-222-4006; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This study investigated patient characteristics in paediatric hospitalisations for hypertrophic cardiomyopathy. We used Nationwide Inpatient Sample, which is the largest all-payer inpatient database in the United States, yielding nationally representative estimates, from 2001 to 2014. ICD-9-CM diagnostic codes identified hospitalisations for patients with hypertrophic cardiomyopathy and <18 years. Outcomes included yearly rate of hospitalisation, death, admission via emergency department, and need for surgery. Predictors of interest were age groups (<1, 1–9, and ⩾10 y/o), sex, and race/ethnicity. Logistic regression modelled associations, adjusted by patient- and hospital-level variables. With 2302 weighted hospitalisations, hospitalisation rates were 0.22 per 100,000 children/year, with higher rates for <1 y/o (0.42) and ⩾10 y/o (0.31). Male-to-female ratios were more prominent in the oldest age group; 2.7:1 in ⩾10 y/o versus less than 1.7:1 for <10 y/o. In-hospital mortality was 1.5%, with highest mortality rates among the <1 y/o (6.3%). Children ⩾10 y/o had 5.59 times higher risk of admission from the emergency department than 1–9 y/o age group. Both ⩾10 and <1 y/o age groups had lower risk of surgical intervention compared to the 1–9 y/o group with odds ratio 0.56 and 0.26, respectively. Black children had higher risk of admission from the emergency department than White children with odds ratio 2.78. A relation between age group and sex was observed, with sex-based differences in prevalence and treatment of hypertrophic cardiomyopathy becoming more pronounced with age. Further studies are needed to clarify mechanisms behind age and racial disparity in hospitalisation, especially admission source.

Keywords

Hypertrophic cardiomyopathyhospitalisationsex differencesage differences
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 3 , March 2019 , pp. 344 - 354
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Sakai-Bizmark R, Webber EJ, Marr EH, Mena LA, Chang RKR. (2019) Patient characteristics and incidence of childhood hospitalisation due to hypertrophic cardiomyopathy in the United States of America 2001–2014. Cardiology in the Young29: 344–354. doi: 10.1017/S1047951118002421

References

1. Lipshultz, SE, Sleeper, LA, Towbin, JA, et al. The incidence of pediatric cardiomyopathy in two regions of the United States. N Engl J Med 2003; 348: 1647–1655.10.1056/NEJMoa021715Google Scholar
2. Colan, SD. Hypertrophic cardiomyopathy in childhood. Heart Fail Clin 2010; 6: 433–444; vii-iii.10.1016/j.hfc.2010.05.004Google Scholar
3. Maron, BJ, Casey, SA, Poliac, LC, Gohman, TE, Almquist, AK, Aeppli, DM. Clinical course of hypertrophic cardiomyopathy in a regional United States cohort. J Am Med Assoc 1999; 281: 650–655.10.1001/jama.281.7.650Google Scholar
4. Grenier, MA, Osganian, SK, Cox, GF, et al. Design and implementation of the North American Pediatric Cardiomyopathy Registry. Am Heart J 2000; 139: S86–S95.Google Scholar
5. Nugent, AW, Daubeney, PE, Chondros, P, et al. The epidemiology of childhood cardiomyopathy in Australia. N Engl J Med 2003; 348: 1639–1646.10.1056/NEJMoa021737Google Scholar
6. Hasegawa, K, Tsugawa, Y, Brown, DFM, Camargo, CA. Childhood asthma hospitalizations in the United States, 2000–2009. J Pediatr 2013; 163: 1127–1133.Google Scholar
7. Hasegawa, K, Tsugawa, Y, Brown, DFM, Mansbach, JM, Camargo, CA. Trends in bronchiolitis hospitalizations in the United States, 2000–2009. Pediatrics 2013; 132: 28–36.10.1542/peds.2012-3877Google Scholar
8. Nandi, D, Lin, KY, O’Connor, MJ, et al. Hospital charges for pediatric heart failure-related hospitalizations from 2000 to 2009. Pediatr Cardiol 2016; 37: 512–518.10.1007/s00246-015-1308-0Google Scholar
9. Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality. Overview of the National (Nationwide) Inpatient Sample (NIS). Rockville, MD, 2015.Google Scholar
10. Muñoz, E, Soldano, R, Laughlin, A, Margolis, IB, Wise, L. Source of admission and cost: public hospitals face financial risk. Am J Public Health 1986; 76: 696–697.10.2105/AJPH.76.6.696Google Scholar
11. Stern, RS, Weissman, JS, Epstein, AM. The emergency department as a pathway to admission for poor and high-cost patients. J Am Med Assoc 1991; 266: 2238–2243.10.1001/jama.1991.03470160070034Google Scholar
12. Baker, LC, Baker, LS. Excess cost of emergency department visits for nonurgent care. Health Aff 1994; 13: 162–171.10.1377/hlthaff.13.5.162Google Scholar
13. Feudtner, C, Hays, RM, Haynes, G, Geyer, JR, Neff, JM, Koepsell, TD. Deaths attributed to pediatric complex chronic conditions: national trends and implications for supportive care services. Pediatrics 2001; 107: e99–103.10.1542/peds.107.6.e99Google Scholar
14. United States Bureau of the Census. Census regions and divisions of the United States, 2015.Google Scholar
15. Healthcare Cost and Utilization Project (HCUP). HCUP NIS Description of Data Elements. Agency for Healthcare Research and Quality, Rockville, MD, 2015.Google Scholar
16. U.S. Department of Commerce United States Census Bureau. Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States: April 1, 2010 to July 1, 2013.Google Scholar
17. Healthcare Cost and Utilization Project (HCUP). HCUP NIS Trend Weights. Agency for Healthcare Research and Quality, Rockville, MD, 2015.Google Scholar
18. Colan, SD, Lipshultz, SE, Lowe, AM, et al. Epidemiology and cause-specific outcome of hypertrophic cardiomyopathy in children – findings from the Pediatric Cardiomyopathy Registry. Circulation 2007; 115: 773–781.10.1161/CIRCULATIONAHA.106.621185Google Scholar
19. Lipshultz, SE, Orav, EJ, Wilkinson, JD, et al. Risk stratification at diagnosis for children with hypertrophic cardiomyopathy: an analysis of data from the Pediatric Cardiomyopathy Registry. Lancet 2013; 382: 1889–1897.Google Scholar
20. Nugent, AW, Daubeney, PEF, Chondros, P, et al. Clinical features and outcomes of childhood hypertrophic cardiomyopathy – results from a national population-based study. Circulation 2005; 112: 1332–1338.10.1161/CIRCULATIONAHA.104.530303Google Scholar
21. Gersh, BJ, Maron, BJ, Bonow, RO, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2011; 58: 2703–2738.Google Scholar
22. Gersh, BJ, Maron, BJ, Bonow, RO, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy. A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2011; 58: E212–E260.10.1016/j.jacc.2011.06.011Google Scholar
23. Ostman-Smith, I, Wettrell, G, Keeton, B, et al. Age- and gender-specific mortality rates in childhood hypertrophic cardiomyopathy. Eur Heart J 2008; 29: 1160–1167.10.1093/eurheartj/ehn122Google Scholar
24. Isobe, N, Toyama, T, Taniguchi, K, et al. Failure to raise blood pressure during exercise is a poor prognostic sign in patients with hypertrophic non-obstructive cardiomyopathy. Circ J 2003; 67: 191–194.10.1253/circj.67.191Google Scholar
25. Spirito, P, Bellone, P, Harris, KM, Bernabo, P, Bruzzi, P, Maron, BJ. Magnitude of left ventricular hypertrophy and risk of sudden death in hypertrophic cardiomyopathy. N Engl J Med 2000; 342: 1778–1785.10.1056/NEJM200006153422403Google Scholar
26. Becton, JL, Cheng, L, Nieman, LZ. The effect of lack of insurance, poverty and paediatrician supply on immunization rates among children 19–35 months of age in the United States. J Eval Clin Pract 2008; 14: 248–253.10.1111/j.1365-2753.2007.00841.xGoogle Scholar
27. Marsh, JD, Lehmann, MH, Ritchie, RH, Gwathmey, JK, Green, GE, Schiebinger, RJ. Androgen receptors mediate hypertrophy in cardiac myocytes. Circulation 1998; 98: 256–261.10.1161/01.CIR.98.3.256Google Scholar
28. Maron, BJ, Haas, TS, Ahluwalia, A, Murphy, CJ, Garberich, RF. Demographics and epidemiology of sudden deaths in young competitive athletes: from the United States National Registry. Am J Med 2016; 129: 1170–1177.10.1016/j.amjmed.2016.02.031Google Scholar
29. Lind, JM, Chiu, C, Ingles, J, et al. Sex hormone receptor gene variation associated with phenotype in male hypertrophic cardiomyopathy patients. J Mol Cell Cardiol 2008; 45: 217–222.Google Scholar
30. Maron, BJ, Gardin, JM, Flack, JM, Gidding, SS, Kurosaki, TT, Bild, DE. Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA study. Coronary artery risk development in (young) adults. Circulation 1995; 92: 785–789.10.1161/01.CIR.92.4.785Google Scholar
31. Movahed, MR, Strootman, D, Bates, S, Sattur, S. Prevalence of suspected hypertrophic cardiomyopathy or left ventricular hypertrophy based on race and gender in teenagers using screening echocardiography. Cardiovasc Ultrasound 2010; 8: 54.10.1186/1476-7120-8-54Google Scholar
32. Dimick, J, Ruhter, J, Sarrazin, MV, Birkmeyer, JD. Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions. Health Aff 2013; 32: 1046–1053.10.1377/hlthaff.2011.1365Google Scholar
33. Bach, PB, Pham, HH, Schrag, D, Tate, RC, Hargraves, JL. Primary care physicians who treat blacks and whites. N Engl J Med 2004; 351: 575–584.10.1056/NEJMsa040609Google Scholar
34. Birkmeyer, JD, Stukel, TA, Siewers, AE, Goodney, PP, Wennberg, DE, Lucas, FL. Surgeon volume and operative mortality in the United States. N Engl J Med 2003; 349: 2117–2127.10.1056/NEJMsa035205Google Scholar
35. Bor, DH, Woolhandler, S, Nardin, R, Brusch, J, Himmelstein, DU. Infective endocarditis in the U.S., 1998–2009: a nationwide study. PLoS One 2013; 8: e60033.10.1371/journal.pone.0060033Google Scholar
36. Pant, S, Patel, NJ, Deshmukh, A, et al. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol 2015; 65: 2070–2076.10.1016/j.jacc.2015.03.518Google Scholar
Supplementary material: PDF

Sakai-Bizmark et al. supplementary material

Table S1

Download Sakai-Bizmark et al. supplementary material(PDF)
PDF 29.9 KB