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Hospitalizations Attributable to Respiratory Infections among Children with Neurologic Disorders
Fiona Havers1, Alicia M Fry1, Jufu Chen1
1Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Insights
Children with neurologic disorders face a significantly higher risk of respiratory infection hospitalizations, up to 5-7 times greater than their peers. This risk is influenced by specific conditions and co-occurring health issues.
Area of Science:
- Pediatric Health
- Neurology
- Infectious Diseases
Background:
- Neurologic disorders affect a significant portion of the pediatric population.
- Respiratory infections are a common cause of hospitalization in children.
- Understanding risk factors for respiratory hospitalizations in children with neurologic conditions is crucial for targeted interventions.
Purpose of the Study:
- To determine the hospitalization rates for respiratory infections in children with neurologic disorders.
- To compare these rates with the general pediatric population.
- To identify specific neurologic disorders and comorbidities associated with increased respiratory hospitalization risk.
Main Methods:
- Analysis of large-scale insurance claims data (commercial and Medicaid) from 2006-2011.
- Inclusion of children under 19 years with International Classification of Diseases, Ninth Revision (ICD-9) codes for neurologic disorders.
- Comparison of hospitalization rates with age-matched control groups.
Main Results:
- Children with neurologic disorders had 5- to 7-fold higher respiratory infection hospitalization rates compared to the general pediatric population.
- Hospitalization rates varied significantly based on the type of neurologic disorder.
- Younger children (<2 years) were most vulnerable, but older children (10-18 years) with neurologic disorders showed a 14.5-fold increased risk.
- Co-occurring conditions like deafness, blindness, and scoliosis were linked to higher respiratory hospitalization rates.
Conclusions:
- Children with neurologic disorders are at substantially elevated risk for respiratory infection hospitalizations.
- The risk is not uniform and depends on the specific neurologic condition, age, and presence of comorbidities.
- These findings highlight the need for tailored preventive strategies and healthcare management for this vulnerable pediatric group.
Objectives:
To characterize respiratory infection hospitalizations in children with neurologic disorders and to compare them with those of the general pediatric population.
Study Design:
We analyzed claims data from commercial insurance and Medicaid enrollees < 19 years of age from July 2006 to June 2011 who had ≥ 1 visit with an International Classification of Diseases, Ninth Revision, diagnosis code for a neurologic disorder. We identified hospitalizations with primary diagnosis codes indicating a respiratory infection and compared hospitalization rates with random samples of children from the commercial and Medicaid databases (comparison groups).
Results:
Among 33,651923 children, 255,046 (0.76%) had ≥ 1 neurologic condition. Among children with neurologic conditions, 8249 of 68,717 hospitalizations (12%) were attributed to a respiratory infection (rate: 21/1000 person-years), although rates varied by disorder. Children with neurologic disorders had greater rates than children in comparison groups (relative rate: Commercial Claims 7.4 [95% CI 7.1-7.7]; Medicaid 5.0 [95% CI 4.8-5.2]). Children < 2 years were most likely to be hospitalized, although those 10-18 years were 14.5 (95% CI 13.3-16.7) times more likely to be hospitalized than age-matched comparison groups. Co-occurring deafness, blindness, and scoliosis were associated with increased respiratory hospitalization rates.
Conclusions:
Children with neurologic disorders are at 5- to 7-fold greater risk for hospitalization from respiratory infections compared with all children, although rates vary widely by disorder type, age, and comorbidities. Children with specific neurologic disorders and those who had co-occurring conditions have the highest rates.
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