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Trends and presentation patterns of acute rheumatic fever hospitalisations in the United States

Published online by Cambridge University Press:  01 October 2019

Tyler Bradley-Hewitt ,
Chris T. Longenecker ,
Vuyisile Nkomo ,
Whitney Osborne ,
Craig Sable ,
Amy Scheel ,
Liesl Zühlke Open the ORCID record for Liesl Zühlke [Opens in a new window] ,
David Watkins  and
Andrea Beaton Open the ORCID record for Andrea Beaton [Opens in a new window]
Tyler Bradley-Hewitt
Affiliation:
Department of Pediatric Cardiology, CS Mott Children’s Hospital, The University of Michigan, Ann Arbor, MI, USA
Chris T. Longenecker
Affiliation:
Department of Cardiology, Case Western Reserve University, Cleveland, OH, USA
Vuyisile Nkomo
Affiliation:
Department of Cardiology, Mayo Clinic, Rochester, MN, USA
Whitney Osborne
Affiliation:
Department of Pediatric Cardiology, Children’s National Health System, Washington, DC, USA
Craig Sable
Affiliation:
Department of Pediatric Cardiology, Children’s National Health System, Washington, DC, USA
Amy Scheel
Affiliation:
Department of Pediatric Cardiology, Children’s National Health System, Washington, DC, USA
Liesl Zühlke
Affiliation:
Department of Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
David Watkins
Affiliation:
Department of Internal Medicine, University of Washington, Seattle, WA, USA
Andrea Beaton*
Affiliation:
Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
*
Author for correspondence: A. Beaton, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. Tel: 513-803-7574; Fax: 513-636-0162; E-mail: [email protected]
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Abstract

Objective:

Rheumatic fever, an immune sequela of untreated streptococcal infections, is an important contributor to global cardiovascular disease. The goal of this study was to describe trends, characteristics, and cost burden of children discharged from hospitals with a diagnosis of RF from 2000 to 2012 within the United States.

Methods:

Using the Kids’ Inpatient Database, we examined characteristics of children discharged from hospitals with the diagnosis of rheumatic fever over time including: overall hospitalisation rates, age, gender, race/ethnicity, regional differences, payer type, length of stay, and charges.

Results:

The estimated national cumulative incidence of rheumatic fever in the United States between 2000 and 2012 was 0.61 cases per 100,000 children. The median age was 10 years, with hospitalisations significantly more common among children aged 6–11 years. Rheumatic fever hospitalisations among Asian/Pacific Islanders were significantly over-represented. The proportion of rheumatic fever hospitalisations was greater in the Northeast and less in the South, although the highest number of rheumatic fever admissions occurred in the South. Expected payer type was more likely to be private insurance, and the median total hospital charges (adjusted for inflation to 2012 dollars) were $16,000 (interquartile range: $8900–31,200). Median length of stay was 3 days, and the case fatality ratio for RF in the United States was 0.4%.

Conclusions:

Rheumatic fever persists in the United States with an overall downwards trend between 2003 and 2012. Rheumatic fever admissions varied considerably based on age group, region, and origin.

Keywords

Rheumatic feverepidemiologydisparity research
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 11 , November 2019 , pp. 1387 - 1390
Copyright
© Cambridge University Press 2019 

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