Increasing Burden of Lyme Carditis in United States Children's Hospitals

Area of Science:

• Pediatric infectious diseases
• Epidemiology
• Health economics

Background:

• Lyme disease is a significant public health concern, particularly in children.
• Carditis is a serious complication of Lyme disease, potentially leading to increased healthcare utilization and costs.
• Understanding trends in Lyme disease and its cardiac manifestations is crucial for resource allocation and public health strategies.

Purpose of the Study:

• To characterize the changing epidemiology of Lyme disease and associated carditis in US children's hospitals.
• To evaluate resource utilization and associated costs for pediatric Lyme disease hospitalizations, comparing cases with and without carditis.
• To hypothesize about the burden and cost-effectiveness of Lyme carditis hospitalizations.

Main Methods:

• Utilized the Pediatric Health Information System (PHIS) database for encounters between 2007 and 2013.
• Identified Lyme disease cases and specifically Lyme carditis cases using diagnostic codes.
• Analyzed demographic, clinical, and resource utilization data, adjusting costs to 2014 US dollars.

Main Results:

• Lyme disease (360 to 672 cases) and Lyme carditis (17 to 40 cases) significantly increased in frequency, primarily in the Midwest.
• Carditis frequency among Lyme disease cases remained stable (p=0.15).
• Lyme carditis hospitalizations were significantly costlier than Lyme disease without carditis (median $9104 vs. $922, p<0.001).

Conclusions:

• The rise in pediatric Lyme carditis cases correlates with increased Lyme disease incidence, not altered virulence.
• Increased serious cardiac events and associated costs underscore the need for Lyme disease prevention and early detection.
• Effective control of Lyme disease spread is essential to mitigate severe outcomes and reduce healthcare expenditures.