A Multicenter Outcomes Analysis of Children With Severe Rhino/Enteroviral Respiratory Infection*. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Spaeder, Michael C.; Custer, Jason W.; Miles, Alison H.; Ngo, Lisa; Morin, Nicholas P.; Scafidi, Susanna; Bembea, Melania M.; Song, Xiaoyan
• Is Part Of: Pediatric critical care medicine. Volume 16:Issue 2(2015)
• Publication Date: 2015-02
• Subjects: Pediatric intensive care -- Periodicals; Pediatric emergencies -- Periodicals; 618.05
• DOI: 10.1097/PCC.0000000000000308
• Languages: English
• ISSNs: 1529-7535

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objectives:</title> <p>To investigate the impact of human rhino/enteroviruses on morbidity and mortality outcomes in children with severe viral respiratory infection.</p> </sec> <sec> <title>Design:</title> <p>Retrospective cohort study.</p> </sec> <sec> <title>Setting:</title> <p>The ICU, either PICU or cardiac ICU, at three urban academic tertiary-care children's hospitals.</p> </sec> <sec> <title>Patients:</title> <p>All patients with laboratory-confirmed human rhino/enteroviruses infection between January 2010 and June 2011.</p> </sec> <sec> <title>Interventions:</title> <p>We captured demographic and clinical data and analyzed associated morbidity and mortality outcomes.</p> </sec> <sec> <title>Measurements and Main Results:</title> <p>There were 519 patients included in our analysis. The median patient age was 2.7 years. The median hospital and ICU lengths of stay were 4 days and 2 days, respectively. Thirty-four percent of patients had a history of asthma, and 25% of patients had a chronic medical condition other than asthma. Thirty-two percent of patients required mechanical ventilation. Eleven patients (2.1%) did not survive to hospital discharge. The rate of viral coinfection was 12.5% and was not associated with mortality. Predisposing factors associated with increased mortality included immunocompromised state (<italic>p</italic> < 0.001), ICU admission severity of illness score (<italic>p</italic> < 0.001), and bacterial coinfection (<italic>p</italic> = 0.003).</p> </sec> <sec> <title>Conclusions:</title> <p>There is substantial morbidity associated with severe respiratory infection due to human rhino/enteroviruses in children. Mortality was less severe than reported in other respiratory viruses such as influenza and respiratory syncytial virus. The burden of illness from human rhino/enteroviruses in the ICU in terms of resource utilization may be considerable.</p> </sec> </abstract>