title: Respiratory syncytial virus hospitalisation trends in children with haemodynamically significant heart disease, 1997-2012.
abstract: OBJECTIVE
  The aim of the study was to evaluate the trends in respiratory syncytial virus-related hospitalisations and associated outcomes in children with haemodynamically significant heart disease in the United States of America. Study design The Kids' Inpatient Databases (1997-2012) were used to estimate the incidence of respiratory syncytial virus hospitalisation among children ⩽24 months with or without haemodynamically significant heart disease. Weighted multivariable logistic regression and chi-square tests were used to evaluate the trends over time and factors associated with hospitalisation, comparing eras before and after publication of the 2003 American Academy of Pediatrics palivizumab immunoprophylaxis guidelines. Secondary outcomes included in-hospital mortality, morbidity, length of stay, and cost.
  
  
  RESULTS
  Overall, 549,265 respiratory syncytial virus-related hospitalisations were evaluated, including 2518 (0.5%) in children with haemodynamically significant heart disease. The incidence of respiratory syncytial virus hospitalisation in children with haemodynamically significant heart disease decreased by 36% when comparing pre- and post-palivizumab guideline eras versus an 8% decline in children without haemodynamically significant heart disease (p<0.001). Children with haemodynamically significant heart disease had higher rates of respiratory syncytial virus-associated mortality (4.9 versus 0.1%, p<0.001) and morbidity (31.5 versus 3.5%, p<0.001) and longer hospital length of stay (17.9 versus 3.9 days, p<0.001) compared with children without haemodynamically significant heart disease. The mean cost of respiratory syncytial virus hospitalisation in 2009 was $58,166 (95% CI:$46,017, $70,315).
  
  
  CONCLUSIONS
  These data provide stakeholders with a means to evaluate the cost-utility of various immunoprophylaxis strategies.
authors.affiliation: 1Duke University School of Medicine,Durham,North Carolina,United States of America.
authors.forename: Patricia Y
authors.initials: PY
authors.lastname: Chu
authors.affiliation: 2Duke Clinical Research Institute,Durham,North Carolina,United States of America.
authors.forename: Christoph P
authors.initials: CP
authors.lastname: Hornik
authors.affiliation: 2Duke Clinical Research Institute,Durham,North Carolina,United States of America.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Li
authors.affiliation: 3Department of Pediatrics,Division of Pediatric Cardiology,Duke University Medical Center,Durham,North Carolina,United States of America.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Campbell
authors.affiliation: 2Duke Clinical Research Institute,Durham,North Carolina,United States of America.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Hill
mesh_terms: D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications* / Q000503:physiopathology; D006439:Hemodynamics; D017052:Hospital Mortality; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000235:genetics*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D004279:DNA, Viral
keywords: CHD; Respiratory syncytial virus; palivizumab