Prognosis and Risk Factors for Congenital Airway Anomalies in Children with Congenital Heart Disease: A Nationwide Population-Based Study in Taiwan.
BACKGROUND
The mortality risk associated with congenital airway anomalies (CAA) in children with congenital heart disease (CHD) is unclear. This study aimed to investigate the factors associated with CAA, and the associated mortality risk, among children with CHD.


METHODS
This nationwide, population-based study evaluated 39,652 children with CHD aged 0-5 years between 2000 and 2011, using the Taiwan National Health Insurance Research Database (NHIRD). We performed descriptive, logistic regression, Kaplan-Meier, and Cox regression analyses of the data.


RESULTS
Among the children with CHD, 1,591 (4.0%) had concomitant CAA. Children with CHD had an increased likelihood of CAA if they were boys (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.33-1.64), infants (OR, 5.42; 95%CI, 4.06-7.24), or had a congenital musculoskeletal anomaly (OR, 3.19; 95%CI, 2.67-3.81), and were typically identified 0-3 years after CHD diagnosis (OR, 1.33; 95%CI 1.17-1.51). The mortality risk was increased in children with CHD and CAA (crude hazard ratio [HR], 2.05; 95%CI, 1.77-2.37), even after adjusting for confounders (adjusted HR, 1.76; 95%CI, 1.51-2.04). Mortality risk also changed by age and sex (adjusted HR and 95%CI are quoted): neonates, infants, and toddlers and preschool children, 1.67 (1.40-2.00), 1.93 (1.47-2.55), and 4.77 (1.39-16.44), respectively; and boys and girls, 1.62 (1.32-1.98) and 2.01 (1.61-2.50), respectively.


CONCLUSIONS
The mortality risk is significantly increased among children with CHD and comorbid CAA. Clinicians should actively seek CAA during the follow-up of children with CHD.
Division of General Pediatrics, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Yu-Sheng
YS
Lee
Division of General Pediatrics, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan; Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Mei-Jy
MJ
Jeng
Division of General Pediatrics, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Pei-Chen
PC
Tsao
Division of General Pediatrics, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Wen-Jue
WJ
Soong
Institute of Public Health and Community Medicine Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Pesus
P
Chou
D000367:Age Factors; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D015619:Respiratory System Abnormalities / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology