Clinical InvestigationPediatricsTrends in endocarditis hospitalizations at US children's hospitals: Impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines
Section snippets
Data source
Data for this multicenter, retrospective study were obtained from the Pediatric Health Information System (PHIS) Database, a large administrative database containing inpatient data from 41 children's hospitals in the United States affiliated with the Child Health Corporation of America (Shawnee Mission, KS). The database currently contains information from >5 million inpatient discharges and has been used extensively in pediatric outcomes research.4, 5, 6 Pediatric Health Information
Study population
A total of 1157 cases of hospitalization for IE during the study period were identified. Study population characteristics are displayed in Table I. Median age was 2.9 years (interquartile range 2.5 months to 12.4 years), and 68% of the cohort was coded as having CHD. In-hospital mortality for the overall cohort was 1.1%.
Hospitalization for IE over time
In analysis of the overall cohort, we did not detect a significant change in the raw number of IE cases over time, before and after the new guidelines were published in 2007:
Discussion
In this multicenter, observational analysis, we did not detect a significant difference in hospitalizations for IE across 37 US children's hospitals before and after revision of the AHA antibiotic prophylaxis guidelines in 2007. Endocarditis, although uncommon, can be associated with significant morbidity and mortality including hospitalization for treatment of the infection, heart failure, embolization, stroke, cardiac valve replacement surgery, and death.1, 7 Mortality associated with IE
Conclusions
In this multicenter analysis, we did not find a significant change in the number of hospitalizations at US children's hospitals for IE before and after revision of the AHA antibiotic prophylaxis guidelines. Evaluation of prescribing patterns and more detailed assessment of high-risk patients are warranted to further characterize outcomes related to the new guidelines.
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Cited by (0)
Funding sources/disclosures: Dr Pasquali: grant support (1K08HL103631-01); National Heart, Lung, and Blood Institute; and the American Heart Association Mid-Atlantic Affiliate Clinical Research Program. Dr Shah: grant support National Institute of Allergy and Infectious Diseases (K01 AI73729) and Robert Wood Johnson Foundation Physician Faculty Scholar program.
J. Michael DiMaio, MD, served as guest editor for this article.