Risk of Respiratory Syncytial Virus Infection in Cyanotic Congenital Heart Disease in a Subtropical Area

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• 作者：Shuenn-Nan Chiu ; MD ; PhD¹ ; Pei-Lan Shao ; MD² ; Hui-Chi Chen ; PhD³ ; Ming-Tai Lin ; MD ; PhD¹ ; Li-Min Huang ; MD ; PhD¹ ; Feng-Yu Kao ; MS⁴ ; San-Kuei Huang ; MD⁴ ; Jou-Kou Wang ; MD ; PhD¹ ; Mei-Hwan Wu ; MD ; PhD¹ ; ^{wumh@ntu.edu.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：AAP ; American Academy of Pediatrics ; CHD ; Congenital heart disease ; hs ; Hemodynamically significant ; ICD-9-CM ; International Classification of Diseases ; Ninth Revision ; Clinical Modification ; LRTI ; Lower respiratory tract infection ; NHI ; National Health Insurance ; RSV ; Respiratory syncytial virus
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：171
• 期：Complete
• 页码：25-30.e1
• 全文大小：429 K

文摘

To compare the risk of respiratory syncytial virus (RSV)-associated hospitalization and analyze the epidemiology of RSV infection in patients with cyanotic and acyanotic congenital heart disease (CHD), we analyzed the nationwide health insurance database from 2005-2010.

Study design

This study included 1050 patients with cyanotic CHD and 7077 patients with acyanotic CHD. Patients with acyanotic CHD were further classified into hemodynamically significant (hs)-acyanotic and non-hs-acyanotic groups according to whether they underwent surgery or took at least 2 anticongestive medications.

Results

RSV-associated hospitalization was higher in the cyanotic group than in hs-acyanotic and non-hs-acyanotic groups both before 1 year of age (4.8% vs 2.1% vs 1.5%, P < .001) and between 1 and 2 years of age (0.9% vs 0.56% vs 0.14%, P = .003). The hospitalization duration, intensive care, ventilator support prevalence, hospitalization cost, and mortality rate were significantly higher in the cyanotic group than in the other 2 groups. Logistic regression revealed that cyanotic CHD was the most significant risk factor for the ventilator support and RSV-associated mortality. In both patients with cyanotic and acyanotic CHD, RSV-associated hospitalization rate was higher in patients aged younger than 1 year and in spring and autumn in Taiwan, a subtropical country.

Conclusions

The results show that patients with cyanotic CHD have a higher risk of severe RSV infection than do those with acyanotic CHD. RSV prophylaxis is more important and may reduce costs more for patients with cyanotic CHD.