title: Risk of Respiratory Syncytial Virus Infection in Cyanotic Congenital Heart Disease in a Subtropical Area.
abstract: OBJECTIVE
  To compare the risk of respiratory syncytial virus (RSV)-associated hospitalization and analyze the epidemiology of RSV infection in patients with cyanotic and acyanotic congenital heart disease (CHD), we analyzed the nationwide health insurance database from 2005-2010.
  
  
  METHODS
  This study included 1050 patients with cyanotic CHD and 7077 patients with acyanotic CHD. Patients with acyanotic CHD were further classified into hemodynamically significant (hs)-acyanotic and non-hs-acyanotic groups according to whether they underwent surgery or took at least 2 anticongestive medications.
  
  
  RESULTS
  RSV-associated hospitalization was higher in the cyanotic group than in hs-acyanotic and non-hs-acyanotic groups both before 1 year of age (4.8% vs 2.1% vs 1.5%, P < .001) and between 1 and 2 years of age (0.9% vs 0.56% vs 0.14%, P = .003). The hospitalization duration, intensive care, ventilator support prevalence, hospitalization cost, and mortality rate were significantly higher in the cyanotic group than in the other 2 groups. Logistic regression revealed that cyanotic CHD was the most significant risk factor for the ventilator support and RSV-associated mortality. In both patients with cyanotic and acyanotic CHD, RSV-associated hospitalization rate was higher in patients aged younger than 1 year and in spring and autumn in Taiwan, a subtropical country.
  
  
  CONCLUSIONS
  The results show that patients with cyanotic CHD have a higher risk of severe RSV infection than do those with acyanotic CHD. RSV prophylaxis is more important and may reduce costs more for patients with cyanotic CHD.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
authors.forename: Shuenn-Nan
authors.initials: SN
authors.lastname: Chiu
authors.affiliation: Department of Laboratory Medicine and Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
authors.forename: Pei-Lan
authors.initials: PL
authors.lastname: Shao
authors.affiliation: Genomics Research Center, Academia Sinica, Taipei, Taiwan.
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
authors.forename: Ming-Tai
authors.initials: MT
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Huang
authors.affiliation: Taiwan National Health Insurance Administration, Taipei, Taiwan.
authors.forename: Feng-Yu
authors.initials: FY
authors.lastname: Kao
authors.affiliation: Taiwan National Health Insurance Administration, Taipei, Taiwan.
authors.forename: San-Kuei
authors.initials: SK
authors.lastname: Huang
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
authors.forename: Jou-Kou
authors.initials: JK
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan. Electronic address: wumh@ntu.edu.tw.
authors.forename: Mei-Hwan
authors.initials: MH
authors.lastname: Wu
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D003490:Cyanosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006439:Hemodynamics; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health; D008297:Male; D000069455:Palivizumab / Q000627:therapeutic use; D012042:Registries; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D012136:Respiratory Syncytial Viruses; D012306:Risk; D012621:Seasons; D013624:Taiwan
chemical_list: D000998:Antiviral Agents; D000069455:Palivizumab