title: Trends in pediatric pulmonary hypertension-related hospitalizations in the United States from 2000-2009.
abstract: There are few data on the epidemiology of pulmonary hypertension (PH)-related hospitalizations in children in the United States. Our aim was to determine hospital mortality, length of hospitalization, and hospital charges pertaining to PH-related hospitalizations and also the effects of codiagnoses and comorbidities. A retrospective review of the Kids' Inpatient Database during the years 2000, 2003, 2006, and 2009 was analyzed for patients ≤20 years of age with a diagnosis of PH by ICD-9 (International Classification of Diseases, Ninth Revision) codes, along with associated diagnoses and comorbidities. Descriptive statistics, including Rao-Scott χ(2), ANOVA, and logistic regression models, were utilized on weighted values with survey analysis procedures. The number of PH-related hospital admissions is rising, from an estimated 7,331 (95% confidence interval [CI]: 5,556-9,106) in 2000 to 10,792 (95% CI: 8,568-13,016) in 2009. While infant age and congenital heart disease were most commonly associated with PH-related hospitalizations, they were not associated with mortality. Overall mortality for PH-related hospitalizations was greater than that for hospitalizations not associated with PH, 5.7% versus 0.4% (odds ratio: 16.22 [95% CI: 14.78%-17.8%], P < 0.001), but mortality is decreasing over time. Sepsis, respiratory failure, acute renal failure, hepatic insufficiency, arrhythmias, and the use of extracorporeal membrane oxygenation are associated with mortality. The number of PH-related hospitalizations is increasing in the United States. The demographics of PH in this study are evolving. Despite the increasing prevalence, mortality is improving.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Frank
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, New York Presbyterian Morgan Stanley Children's Hospital-Columbia University Medical Center, New York, New York, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Crystal
authors.affiliation: Division of Cardiovascular Surgery, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.
authors.forename: David L S
authors.initials: DL
authors.lastname: Morales
authors.affiliation: Department of Biostatistics, Westat, Houston, Texas, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Gerald
authors.affiliation: Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Hanna
authors.affiliation: Section of Pulmonology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
authors.forename: George B
authors.initials: GB
authors.lastname: Mallory
authors.affiliation: Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Rossano
keywords: epidemiology; pediatrics; pulmonary hypertension; survival