Factors affecting in-hospital mortality among pediatric patients with myocarditis treated with mechanical circulatory...

Area of Science:

• Pediatric Cardiology
• Critical Care Medicine
• Cardiovascular Research

Background:

• Pediatric myocarditis often necessitates mechanical circulatory support (MCS) for circulatory failure.
• Despite advancements, in-hospital mortality rates for pediatric patients with myocarditis undergoing MCS remain a significant concern.
• Identifying mortality predictors is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

• To identify factors associated with in-hospital mortality in pediatric patients with myocarditis treated with MCS.
• To inform clinical strategies aimed at reducing mortality in this patient group.

Main Methods:

• Retrospective cohort study utilizing Japan's national inpatient database (Diagnosis Procedure Combination).
• Inclusion criteria: Patients aged <16 years admitted for myocarditis between July 2010 and March 2018.
• Analysis focused on 98 eligible patients treated with MCS, excluding those deceased within 24 hours of admission.

Main Results:

• Overall in-hospital mortality was 22% among the 98 eligible pediatric patients.
• In-hospital mortality was significantly higher in patients younger than 2 years (OR, 6.57; 95% CI, 1.89-22.87).
• Patients who received cardiopulmonary resuscitation (CPR) also had significantly higher in-hospital mortality (OR, 4.70; 95% CI, 1.51-14.63).

Conclusions:

• In-hospital mortality for pediatric myocarditis patients on MCS is high.
• Younger age (<2 years) and the need for CPR are significant risk factors for mortality.
• These findings highlight critical subgroups requiring intensified monitoring and potentially tailored interventions.