title: Resource utilization and outcomes of infective endocarditis in children.
abstract: OBJECTIVE
  To evaluate resource use and outcomes of infective endocarditis in children with and without preexisting heart disease via a national cohort.
  
  
  METHODS
  Children <19 years of age hospitalized from 2004 to 2010 with infective endocarditis at 37 centers in the Pediatric Health Information Systems database were included. We excluded children primarily hospitalized for chronic medical conditions. We used regression analysis to evaluate factors associated with poor outcomes (defined as mortality, mechanical cardiac support, or stroke).
  
  
  RESULTS
  There were 1033 cases of infective endocarditis, of which 663 had heart disease and 370 did not. Compared with the group without heart disease, infective endocarditis in the cohort with heart disease occurred at younger age, was more commonly attributable to streptococcus, was more likely to require cardiac surgery for infective endocarditis, and was associated with a lower risk of stroke. Mortality was 6.7% (n = 45) and 3.5% (n = 13) in groups with and without heart disease, respectively. Factors associated with poor outcome in the cohort with heart disease included greater risk of mortality score (OR 7.9), mechanical ventilation (OR 3.1), use of antiarrhythmics (OR 2.7), and use of vasoactive medications (OR 3.8). In the cohort without heart disease, factors associated with poor outcome included renal failure (OR 19.3), greater risk of mortality score (OR 4.2), use of antiarrhythmics (OR 3.8), and mechanical ventilation (OR 2.2). Median charge of hospitalization was $131,893 in the group without heart disease and $140,655 in the group with heart disease.
  
  
  CONCLUSIONS
  Infective endocarditis remains a significant cause of morbidity, mortality, and resource use particularly in children with heart disease.
authors: Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT.
authors: Adam L
authors: AL
authors: Ware
authors: Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT.
authors: Lloyd Y
authors: LY
authors: Tani
authors: Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT.
authors: Hsin-Yi
authors: HY
authors: Weng
authors: Intermountain Health Care, Salt Lake City, UT.
authors: Jacob
authors: J
authors: Wilkes
authors: Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT. Electronic address: shaji.menon@imail.org.
authors: Shaji C
authors: SC
authors: Menon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult