title: Characteristics and outcomes of heart failure-related intensive care unit admissions in children with cardiomyopathy.
abstract: OBJECTIVE
  The purpose of this study was to describe patient characteristics and outcomes of heart failure (HF)-related intensive care unit (ICU) hospitalizations in children with cardiomyopathy (CM).
  
  
  RESULTS
  A query of the Pediatric Health Information System database, a large administrative and billing database of 43 tertiary children's hospitals, was performed. A total of 17,309 HF-related ICU hospitalizations from 2005 to 2010 of 14,985 children ≤18 years old were analyzed. Of those, 2,058 (12%) hospitalizations for CM-HF in 1,599 (11%) children were identified. Classification into CM subtypes was not possible owing to database limitations. The number of yearly CM-HF hospitalizations significantly increased during the study period (P = .036). Overall mortality was 11%, and cardiac transplantation occurred in 20% of hospitalizations. Mechanical circulatory support (MCS) was used in 261 (13%) of hospitalizations. Renal failure, MCS, respiratory failure, sepsis, and vasoactive medications were associated with mortality on multivariable analysis. Significant comorbidities associated with these hospitalizations included arrhythmias in 42%, renal failure in 13%, cerebrovascular disease in 6%, and hepatic impairment in 5%.
  
  
  CONCLUSIONS
  HF-related ICU hospitalizations in children with cardiomyopathy are increasing. These children are at high risk for poor outcomes with an in-hospital mortality of 11%.
authors.affiliation: Department of Pediatrics, Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine, Houston, Texas; Department of Pediatrics, The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio. Electronic address: pirouz.shamszad@cchmc.org.
authors.forename: Pirouz
authors.initials: P
authors.lastname: Shamszad
authors.forename: Matthew
authors.initials: M
authors.lastname: Hall
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Rossano
authors.forename: Susan W
authors.initials: SW
authors.lastname: Denfield
authors.forename: Jarrod D
authors.initials: JD
authors.lastname: Knudson
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Penny
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Towbin
authors.forename: Antonio G
authors.initials: AG
authors.lastname: Cabrera
mesh_terms: D000293:Adolescent; D009202:Cardiomyopathies / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000639:trends*; D008297:Male; D010343:Patient Admission / Q000639:trends*; D016896:Treatment Outcome
keywords: Pediatrics; inpatient; mortality