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Demographic and Clinical Characteristics of Children with Primary Cardiac Tumors Hospitalized from 1997 to 2019 in
Balagangadhar R Totapally1,2, Seevitha Totapalli3, Anushree Malhotra-Hans4
1Division of Critical Care Medicine, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL, 33155, USA. balagangadhar.totapally@nicklaushealth.org.
Insights
Pediatric primary cardiac tumors are rare, most often benign, and prevalent in young children. This study analyzed national data, revealing an increasing prevalence and common associations with tuberous sclerosis.
Area of Science:
- Pediatric Cardiology
- Oncology
- Epidemiology
Background:
- Primary cardiac tumors in children are rare but can cause significant complications like valve obstruction and conduction abnormalities.
- Limited multi-site or national data exists on the epidemiology and characteristics of pediatric cardiac tumors.
- Understanding the prevalence and clinical features of these tumors is crucial for diagnosis and management.
Purpose of the Study:
- To determine the prevalence of primary cardiac tumors in hospitalized children in the US from 1997 to 2019.
- To analyze the demographic and clinical characteristics of pediatric patients diagnosed with cardiac tumors.
- To identify trends in the incidence and associated conditions of pediatric cardiac tumors over time.
Main Methods:
- A cross-sectional analysis was performed using the Healthcare Cost and Utilization Project's Kid's Inpatient Database (1997-2019).
- Pediatric cardiac tumors were identified using International Classification of Diseases (ICD-9 and ICD-10) diagnosis codes.
- Prevalence rates were calculated per 100,000 hospital discharges and per million age-specific US population; Chi-square tests analyzed demographic and clinical variables and trends.
Main Results:
- A total of 3,166 primary cardiac tumors were identified among 55.1 million hospital discharges, yielding a hospitalization rate of 5.8 per 100,000 discharges.
- The prevalence of pediatric cardiac tumors increased significantly from 1997 to 2019 (p < 0.001).
- Most tumors (88.9%) were benign, predominantly affecting neonates and children under 5 years old. Tuberous sclerosis was associated in 51.9% of cases. Common comorbidities included cardiac arrhythmias (19.2%) and seizures (28%).
Conclusions:
- Primary cardiac tumors are rare in children, with a notable increase in prevalence observed over the study period.
- These tumors most commonly affect neonates and young children, are frequently benign, and often associated with tuberous sclerosis.
- While overall hospital mortality was low (1.6%), a significant proportion of patients required cardiac surgical procedures (13.9%).
Abstract:
Cardiac tumors in children, although rare, can lead to obstruction of valves or cardiac conduction problems. Large multi-site or national data on pediatric cardiac tumors is lacking. The objective of this study was to determine the prevalence of primary cardiac tumors in hospitalized children from 1997 to 2019 in the US and analyze the demographic and clinical characteristics of children with cardiac tumors. We conducted a cross-sectional analysis using the Healthcare Cost and Utilization Project's Kid's Inpatient Database from 1997 to 2019. Children with cardiac tumors were identified using ICD-9 and ICD-10 diagnosis codes. The prevalence is presented per 100,000 hospital discharges and 1,000,000 age-specific US population. The Chi-square test was used to compare the discharges with and without cardiac tumors for demographic and clinical variables. The Chi-square for linear trend (Extended Mantel-Haenszel) test was used for trend analyses. There were 3,166 discharges with primary cardiac tumors out of a total of 55.1 million discharges with a hospitalization rate of 5.8 per 100,000 discharges and 4.82 per million US children. Out of all children with cardiac tumors, 29.9% were neonates, 20.7% were infants, and 71% were children less than 5 years of age. Males comprised 52.9% of all cases. An increase in the prevalence of cardiac tumors from 1997 to 2019 was observed (p < 0.001). Of all admissions with cardiac tumors, 88.9% were reported benign, and 37.3% were admitted to Children's Hospitals. Cardiac arrhythmias were reported in 19.2%, seizures in 28%, and stroke in 1.4%. 51.9% of cases were associated with tuberous sclerosis. Cardiac surgical procedures were performed in 13.9% of patients. The overall hospital mortality rate was 1.6%. Primary cardiac tumor is a rare condition in children and is most common in neonates and young children. Most pediatric cardiac tumors are benign, and many are associated with tuberous sclerosis.
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