title: A multicenter outcomes analysis of children with severe rhino/enteroviral respiratory infection.
abstract: OBJECTIVE
  To investigate the impact of human rhino/enteroviruses on morbidity and mortality outcomes in children with severe viral respiratory infection.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  The ICU, either PICU or cardiac ICU, at three urban academic tertiary-care children's hospitals.
  
  
  METHODS
  All patients with laboratory-confirmed human rhino/enteroviruses infection between January 2010 and June 2011.
  
  
  METHODS
  We captured demographic and clinical data and analyzed associated morbidity and mortality outcomes.
  
  
  RESULTS
  There were 519 patients included in our analysis. The median patient age was 2.7 years. The median hospital and ICU lengths of stay were 4 days and 2 days, respectively. Thirty-four percent of patients had a history of asthma, and 25% of patients had a chronic medical condition other than asthma. Thirty-two percent of patients required mechanical ventilation. Eleven patients (2.1%) did not survive to hospital discharge. The rate of viral coinfection was 12.5% and was not associated with mortality. Predisposing factors associated with increased mortality included immunocompromised state (p < 0.001), ICU admission severity of illness score (p < 0.001), and bacterial coinfection (p = 0.003).
  
  
  CONCLUSIONS
  There is substantial morbidity associated with severe respiratory infection due to human rhino/enteroviruses in children. Mortality was less severe than reported in other respiratory viruses such as influenza and respiratory syncytial virus. The burden of illness from human rhino/enteroviruses in the ICU in terms of resource utilization may be considerable.
authors: 1Division of Critical Care Medicine, Children's National Health System, Washington, DC. 2Division of Pediatric Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD. 3Division of Pediatric Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD. 4Biostatistics Center, George Washington University, Rockville, MD. 5Department of Pediatrics, University of Maryland Medical Center, Baltimore, MD. 6Division of Infectious Disease, Children's National Health System, Washington, DC.
authors: Michael C
authors: MC
authors: Spaeder
authors: Jason W
authors: JW
authors: Custer
authors: Alison H
authors: AH
authors: Miles
authors: Lisa
authors: L
authors: Ngo
authors: Nicholas P
authors: NP
authors: Morin
authors: Susanna
authors: S
authors: Scafidi
authors: Melania M
authors: MM
authors: Bembea
authors: Xiaoyan
authors: X
authors: Song
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017281:Cost of Illness; D003422:Critical Care / Q000706:statistics & numerical data; D004219:District of Columbia / Q000453:epidemiology; D004770:Enterovirus / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008396:Maryland / Q000453:epidemiology; D010850:Picornaviridae Infections / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D012229:Rhinovirus / Q000302:isolation & purification; D012720:Severity of Illness Index; D016896:Treatment Outcome