Risk factors for RSV hospitalisation in children with heart disease

kim kristensen ^1*, lone Graff Stensballe ², jesper vandborg bjerre ³, Ditte Roth ⁴, niels fisker ⁵, Thomas Kongstad ⁶, Anne Louise Svendsen ⁷ and bent Windelborg Nielsen ⁸

¹ Paediatric Clinic 2, University Hospital Rigshospitalet, Denmark
² Department of Epidemiological Research, Statens Seruminstitut, Copenhagen, Denmark
³ Department of Paediatrics, University Hospital Skejby, Denmark
⁴ Department of Paediatrics, University Hospital Odense, Denmark
⁵ Paediatric Department, University Hospital Odense, Denmark
⁶ Paediatric Department, County Hospital Hillerød, Denmark
⁷ Department of Biostatistics, University of Copenhagen, Denmark
⁸ Paediatric Department, University Hospital, Skejby, Denmark

^* To whom correspondence should be addressed. E-mail: kimk{at}dadlnet.dk.

Accepted 9 June 2009

Abstract

Objective: To assess risk and risk factors for RSV hospitalisation and determinants of severity of RSV disease in children with heart disease.

Methods: By using a database on RSV tests in Denmark we identified all children with RSV diagnosed with heart disease in Denmark from January 1996 through April 2003. For each case child one control child matched for age and centre was drawn from the population of children with heart disease. Clinical information was obtained through review of all records.

Results: Data were obtained on 313 pairs. Median age at admission was 280 days (range: 15 – 2379). In the multivariate analysis predictors of RSV hospitalisation were Down syndrome (odds ratio (OR) = 3.24 (95 % confidence interval: 1.80 – 5.80)), cardiomyopathy (OR = 5.84 (1.26 – 27.16)) and haemodynamically significant heart disease (OR = 1.53 (1.04 – 2.26)). During RSV hospitalisation predictors of need for respiratory support (supplemental oxygen, nasal continuous positive airway pressure or mechanical ventilation) were young age (relative risk (RR) = 0.47 (0.32 – 0.67) per additional year of age) and cardiac decompensation (RR = 1.81 (1.02 – 3.23)). The incidence rate of RSV hospitalisation among children with any heart disease aged 0 – 23 months was 5.65 per 100 child years.

Conclusion: In children with heart disease risk factors for RSV admission are Down syndrome, cardiomyopathy and haemodynamically significant heart disease. Young age and cardiac decompensation are associated with more severe course of RSV disease.