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Acute respiratory infections in hospitalised infants with congenital heart disease

Published online by Cambridge University Press:  14 December 2020

Namrata Ahuja Open the ORCID record for Namrata Ahuja [Opens in a new window] ,
Wendy J Mack ,
Susan Wu ,
John C Wood  and
Christopher J Russell
Namrata Ahuja*
Affiliation:
Division of Hospital Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Wendy J Mack
Affiliation:
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Susan Wu
Affiliation:
Division of Hospital Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
John C Wood
Affiliation:
Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Division of Cardiology, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Christopher J Russell
Affiliation:
Division of Hospital Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
*
Address for correspondence: Namrata Ahuja, MD, Division of Hospital Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS #94, Los Angeles, CA90027. Tel: 323-361-6277. E-mail: [email protected]
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Abstract

Objectives:

To assess the overall burden and outcomes of acute respiratory infections in paediatric inpatients with congenital heart disease (CHD).

Methods:

This is a retrospective cross-sectional study of non-neonates <1 year with CHD in the Kid’s Inpatient Database from 2012. We compared demographics, clinical characteristics, cost, length of stay, and mortality rate for those with and without respiratory infections. We also compared those with respiratory infections who had critical CHD versus non-critical CHD. Multi-variable regression analyses were done to look for associations between respiratory infections and mortality, length of stay, and cost.

Results:

Of the 28,696 infants with CHD in our sample, 26% had respiratory infections. Respiratory infection-associated hospitalisations accounted for $440 million in costs (32%) for all CHD patients. After adjusting for confounders including severity, mortality was higher for those with respiratory infections (OR 1.5, p = 0.003), estimated mean length of stay was longer (14.7 versus 12.2 days, p < 0.001), and estimated mean costs were higher ($53,760 versus $46,526, p < 0.001). Compared to infants with respiratory infections and non-critical CHD, infants with respiratory infections and critical CHD had higher mortality (4.5 versus 2.3%, p < 0.001), longer mean length of stay (20.1 versus 15.5 days, p < 0.001), and higher mean costs ($94,284 versus $52,585, p < 0.001).

Conclusion:

Acute respiratory infections are a significant burden on infant inpatients with CHD and are associated with higher mortality, costs, and longer length of stay; particularly in those with critical CHD. Future interventions should focus on reducing the burden of respiratory infections in this population.

Keywords

Respiratory infectionbronchiolitiscongenital heart disease
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 4 , April 2021 , pp. 547 - 555
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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