National hospitalization trends for pediatric pneumonia and associated complications.
OBJECTIVE
To determine current rates of and trends in hospitalizations for community-acquired pneumonia (CAP) and CAP-associated complications among children.


METHODS
We performed a cross-sectional, retrospective, cohort study by using the 1997, 2000, 2003, and 2006 Kids' Inpatient Database. National estimates for CAP and CAP-associated local and systemic complication rates were calculated for children < or =18 years of age. Patients with comorbid conditions or in-hospital birth status were excluded. Percentage changes were calculated by using 1997 (before heptavalent pneumococcal conjugate vaccine [PCV7]) and 2006 (after PCV7) data.


RESULTS
There were a total of 619,102 CAP discharges for 1997, 2000, 2003, and 2006, after application of inclusion and exclusion criteria. Overall rates of CAP discharges did not change substantially between 1997 and 2006, but stratification according to age revealed a 22% decrease for children <1 year of age, minimal change for children 1 to 5 years of age, and increases for children 6 to 12 years (22%) and > or =13 years (41%) of age. Systemic complication rates were highest among children <1 year of age but decreased by 36%. In all other age groups, systemic complication rates remained stable. Local complication rates increased 78% overall. Children 1 to 5 years of age had the highest local complication rates.


CONCLUSIONS
After the introduction of PCV7 in 2000, rates of CAP-associated systemic complications decreased only for children <1 year of age. Rates of pediatric CAP-associated local complications are increasing in all age groups.
Lee
Grace E
GE
Children's Hospital of Philadelphia, Division of General Padiatrics, Philadelphia, PA 19104, USA.
Lorch
Scott A
SA
Sheffler-Collins
Seth
S
Kronman
Matthew P
MP
Shah
Samir S
SS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000150:complications / Q000534:rehabilitation / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy; D012042:Registries; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines