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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Respiratory syncytial virus-associated mortality in hospitalized infants and young children
Carrie L Byington1, Jacob Wilkes2, Kent Korgenski2
1Department of Pediatrics, University of Utah, Salt Lake City, Utah; and carrie.byington@hsc.utah.edu.
Insights
Deaths from respiratory syncytial virus (RSV) are rare in hospitalized children today. Infants with complex chronic conditions are most affected, but RSV
Area of Science:
- Pediatric critical care medicine
- Infectious disease epidemiology
- Public health surveillance
Background:
- Respiratory syncytial virus (RSV) is a leading cause of infant hospitalization.
- Existing mortality data for RSV are outdated, necessitating contemporary analysis.
- Understanding current RSV-associated mortality is crucial for public health strategies.
Purpose of the Study:
- To determine the contemporary mortality rate associated with RSV in hospitalized children under two years old.
- To update estimates of annual RSV-related deaths using recent data.
- To identify risk factors and patient populations most vulnerable to severe outcomes from RSV.
Main Methods:
- Utilized large administrative datasets: Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) and Pediatric Health Information System (PHIS).
- Analyzed data from 2000 to 2011, identifying hospitalizations with relevant ICD-9-CM diagnosis codes for RSV infection.
- Calculated mortality rates per 10,000 admissions and analyzed trends over time.
Main Results:
- RSV-associated mortality was low: 9.0 deaths/10,000 admissions (KID) and 25.4 deaths/10,000 admissions (PHIS).
- Primary RSV diagnosis mortality rates decreased significantly by 2011 (OR: 0.27).
- The majority of deaths occurred in infants with complex chronic conditions or other acute conditions like sepsis.
Conclusions:
- RSV-associated deaths are uncommon in the 21st century.
- Children with complex chronic conditions represent the majority of fatalities.
- The direct contribution of RSV to mortality in these vulnerable children remains unclear.
Background And Objective:
Respiratory syncytial virus (RSV) is a common cause of pediatric hospitalization, but the mortality rate and estimated annual deaths are based on decades-old data. Our objective was to describe contemporary RSV-associated mortality in hospitalized infants and children aged <2 years.
Methods:
We queried the Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) for 2000, 2003, 2006, and 2009 and the Pediatric Health Information System (PHIS) administrative data from 2000 to 2011 for hospitalizations with International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for RSV infection and mortality.
Results:
The KID data sets identified 607 937 RSV-associated admissions and 550 deaths (9.0 deaths/10 000 admissions). The PHIS data set identified 264 721 RSV-associated admissions and 671 deaths (25.4 deaths/10 000 admissions) (P < .001 compared with the KID data set). The 2009 KID data set estimated 42.0 annual deaths (3.0 deaths/10 000 admissions) for those with a primary diagnosis of RSV. The PHIS data set identified 259 deaths with a primary diagnosis of RSV, with mortality rates peaking at 14.0/10 000 admissions in 2002 and 2003 and decreasing to 4.0/10 000 patients by 2011 (odds ratio: 0.27 [95% confidence interval: 0.14-0.52]). The majority of deaths in both the KID and PHIS data sets occurred in infants with complex chronic conditions and in those with other acute conditions such as sepsis that could have contributed to their deaths.
Conclusions:
Deaths associated with RSV are uncommon in the 21st century. Children with complex chronic conditions account for the majority of deaths, and the relative contribution of RSV infection to their deaths is unclear.
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