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Association between CHD and cerebral abscess: insights from a national database
Keats Ewing1, Rohit Seath Loomba1, Saul Flores2
1Department of Pediatrics, Division of Cardiology, Ann and Robert H Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Insights
Congenital heart disease (CHD) is not associated with an increased risk of cerebral abscess in children. This study found that children with CHD were less likely to develop brain abscesses compared to those without CHD.
Area of Science:
- Pediatric Neurology
- Cardiology
- Infectious Diseases
Background:
- Congenital heart disease (CHD) has been historically linked to cerebral abscess development.
- Understanding this association is crucial for pediatric patient care.
Purpose of the Study:
- To investigate the association between congenital heart disease (CHD) and the occurrence of cerebral abscess in an inpatient pediatric population.
- To determine if CHD increases the risk of cerebral abscess in children.
Main Methods:
- Retrospective cohort study using the Pediatric Health Information System database (2016-2021).
- Analyzed data from 426,029 pediatric intensive care unit admissions.
- Compared cerebral abscess incidence in patients with and without CHD.
Main Results:
- A total of 1,387 (0.3%) patients developed cerebral abscesses.
- 88 (0.1%) of 80,927 patients with CHD experienced a cerebral abscess (OR 0.29).
- Seizures, cerebral edema, stroke, shock, surgery, and older age increased abscess risk; mortality was not associated.
Conclusions:
- Patients with CHD were less likely to develop cerebral abscesses compared to those without CHD.
- Cerebral abscess is a rare complication in the contemporary pediatric inpatient population.
- No significant association found between CHD and cerebral abscess development.
Abstract:
CHD has been historically associated with the development of cerebral abscess. This retrospective cohort study examines the association of CHD with the occurrence of cerebral abscess in an inpatient paediatric population. We analysed data from the Pediatric Health Information System database, an administrative database that captures data from participating children's hospitals in the United States. We included all patients admitted to participating paediatric ICUs between 2016 and 2021 for a total of 426,029 admissions. Including all admissions, 1,387 (0.3%) patients experienced a cerebral abscess, and of 80,927 (19%) patients with CHD, only 88 (0.1%) experienced a cerebral abscess (odds ratio 0.29, 0.23-0.36). Patients with seizures, cerebral oedema, stroke, shock, surgical intervention, and older age were associated with increased risk of development of a cerebral abscess. Interestingly, the development of a cerebral abscess was not associated with an increased risk of mortality (p = 0.937). When compared to patients without CHD admitted to the paediatric ICU, those with CHD appear less likely to develop a cerebral abscess. This study reiterates that cerebral abscess is a rare occurrence and does not demonstrate any significant association with CHD in a contemporary, inpatient population in the United States.
