Morbidity and mortality after RSV-associated hospitalizations among premature Canadian infants☆
Section snippets
Methods
Data for this study were obtained from the Canadian Institute of Health Information (CIHI): Discharge Abstract Database (DAD) and Hospital Morbidity Database (HMD). These databases capture all hospital separations including transfers, discharges, and deaths, with data on a per-patient basis that describe all elements of in-hospital care. The preterm infant cohort consisted of infants born between 1997 and 2000 at 32 to 35 weeks gestation, who were identified on the basis of the International
Results
A total of 2415 infants with RSV hospitalizations were identified. Of these, 2149 (88.9%) were hospitalized for probable RSV bronchiolitis, 114 (4.8%) for probable RSV pneumonia, and 152 (6.3%) for confirmed RSV pneumonia or bronchiolitis. The study included 20,254 matched control infants; 46% male and 54% female infants. The mean (SD) age at the index admission was 7.7 (5.5) months, with a range of 0.5 to 11.2 months and a median of 6.9 months. The mean duration of follow-up since the index
Discussion
There is strong evidence that preterm infants are at high risk for several chronic and acute conditions.1., 2., 3., 4., 5. Preterm infants are at increased risk of RSV infections severe enough to lead to hospitalization, and these infections and hospitalizations are potentially preventable.10., 11., 12., 13., 14., 15., 16., 17., 18., 19., 20., 21., 22., 23. Results from several studies show that prophylaxis with palivizumab (Synagis), a humanized immunoglobulin, monoclonal antibody, is safe and
Conclusions
Severe RSV infections leading to hospitalization in 32 to 35 weeks GA preterm infants are associated with an increased rate of morbidity, mortality, and health care use for respiratory conditions during the 1 to 4 years subsequent to the index infection. The results of our study identified an important signal regarding the impact of RSV infections on nonrespiratory morbidity and mortality that requires further investigation.
John V. Williams, MD, Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tenn:
In terms of your finding of a greater occurrence of fever in the follow-up period in infants hospitalized for RSV, I can't think of a biological explanation for recurrent fever after primary RSV infection. This suggests that there are in fact differences between the populations that are not apparent at first glance.
Dr Sampalis:
We removed from analysis all children with congenital abnormalities or any other chronic condition that might predispose them to hospitalizations, particularly for respiratory
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2014, International Journal of Medical InformaticsCitation Excerpt :Each year, 3–5% of annual births belong to this cohort [145]. If no preventative treatment is used, 2–10% of infants in this cohort will experience RSV hospitalization [146], which is associated with a large increase in subsequent healthcare resource usage and mortality [147]. For infants in this cohort, Simões et al. [144] used discriminatory function analysis to build a model to predict RSV hospitalization.
Should respiratory care in preterm infants include prophylaxis against respiratory syncytial virus infection? The case in favour
2013, Paediatric Respiratory Reviews
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Supported in part by contributions from JSS Medical Research, Inc.