Publication: Respiratory infection in congenital cardiac disease. Hospitalizations in young children in Spain during 2004 and 2005: the CIVIC Epidemiologic Study.
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Identifiers
Date
2007-08
Authors
Medrano, Constancio
Garcia-Guereta, Luis
Grueso, Josefina
Insa, Beatriz
Ballesteros, Fernando
Casaldaliga, Jaume
Cuenca, Victorio
Escudero, Fuensanta
Garcia de la Calzada, Lola
Luis, Maite
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
Cambridge University Press
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Abstract
OBJECTIVES
To evaluate the rate of hospitalization for acute respiratory tract infection in children less than 24 months with haemodynamically significant congenital cardiac disease, and to describe associated risk factors, preventive measures, aetiology, and clinical course.
MATERIALS AND METHODS
We followed 760 subjects from October 2004 through April 2005 in an epidemiological, multicentric, observational, follow-up, prospective study involving 53 Spanish hospitals.
RESULTS
Of our cohort, 79 patients (10.4%, 95% CI: 8.2%-12.6%) required a total of 105 admissions to hospital related to respiratory infections. The incidence rate was 21.4 new admissions per 1000 patients-months. Significant associated risk factors for hospitalization included, with odds ratios and 95% confidence intervals shown in parentheses: 22q11 deletion (8.2, 2.5-26.3), weight below the 10th centile (5.2, 1.6-17.4), previous respiratory disease (4.5, 2.3-8.6), incomplete immunoprophylaxis against respiratory syncytial virus (2.2, 1.2-3.9), trisomy 21 (2.1, 1.1-4.2), cardiopulmonary bypass (2.0, 1.1-3.4), and siblings aged less than 11 years old (1.7, 1.1-2.9). Bronchiolitis (51.4%), upper respiratory tract infections (25.7%), and pneumonia (20%) were the main diagnoses. An infectious agent was found in 37 cases (35.2%): respiratory syncytial virus in 25, Streptococcus pneumoniae in 5, and Haemophilus influenzae in 4. The odds ratio for hospitalization due to infection by the respiratory syncytial virus increases by 3.05 (95% CI: 2.14 to 4.35) in patients with incomplete prophylaxis. The median length of hospitalization was 7 days. In 18 patients (17.1%), the clinical course of respiratory infection was complicated and 2 died.
CONCLUSIONS
Hospital admissions for respiratory infection in young children with haemodynamically significant congenital cardiac disease are mainly associated with non-cardiac conditions, which may be genetic, malnutrition, or respiratory, and to cardiopulmonary bypass. Respiratory syncytial virus was the most commonly identified infectious agent. Incomplete immunoprophylaxis against the virus increased the risk of hospitalization.
Description
Journal Article; Research Support, Non-U.S. Gov't;
MeSH Terms
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Pasteurellaceae Infections::Haemophilus Infections
Medical Subject Headings::Diseases::Congenital, Hereditary, and Neonatal Diseases and Abnormalities::Congenital Abnormalities::Cardiovascular Abnormalities::Heart Defects, Congenital
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence
Medical Subject Headings::Named Groups::Persons::Age Groups::Infant
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections::Pneumococcal Infections
Medical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Mononegavirales Infections::Paramyxoviridae Infections::Pneumovirus Infections::Respiratory Syncytial Virus Infections
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Respiratory Tract Infections
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Pasteurellaceae Infections::Haemophilus Infections
Medical Subject Headings::Diseases::Congenital, Hereditary, and Neonatal Diseases and Abnormalities::Congenital Abnormalities::Cardiovascular Abnormalities::Heart Defects, Congenital
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence
Medical Subject Headings::Named Groups::Persons::Age Groups::Infant
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections::Pneumococcal Infections
Medical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Mononegavirales Infections::Paramyxoviridae Infections::Pneumovirus Infections::Respiratory Syncytial Virus Infections
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Respiratory Tract Infections
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors
DeCS Terms
CIE Terms
Keywords
Infant, Congenitally malformed hearts, Haemodynamically significant, respiratory syncytial virus, Trisomy 21, Infecciones por Haemophilus, Cardiopatías congénitas, Infecciones por virus sincitial respiratorio, Estudios de cohortes, España
Citation
Medrano C, Garcia-Guereta L, Grueso J, Insa B, Ballesteros F, Casaldaliga J, et al. Respiratory infection in congenital cardiac disease. Hospitalizations in young children in Spain during 2004 and 2005: the CIVIC Epidemiologic Study. Cardiol Young. 2007; 17(4):360-71