Retrospective cohort study design.
SETTING: The C. S. Mott Children's Hospital, University of Michigan Medical Center.
PATIENTS: None.
MEASUREMENTS AND MAIN RESULTS: We retrospectively examined the charts of 740 patients hospitalized at our children's hospital from July 1, 1983 to June 30, 1990 with symptomatic
respiratory syncytial virus infection to assess morbidity and mortality outcomes. Seventy-nine patients had
congenital heart disease and 40 of these patients had
pulmonary hypertension. For the entire cohort and a subset of patients with
community-acquired infection, those patients with
congenital heart disease had longer durations of hospitalization and greater need for, and days of, both
intensive care and
mechanical ventilation than patients without
congenital heart disease. Mortality risk for respiratory syncytial virus
community-acquired infection was not different for
congenital heart disease vs. noncongenital
heart disease patients (0.0% vs. 0.2%; p = 1.00). When examining only patients with
congenital heart disease, those patients with
pulmonary hypertension had increased hospital days and greater
intensive care and
mechanical ventilation durations compared with patients without this diagnosis. The overall mortality rate was low and was equally low for
congenital heart disease groups with or without
pulmonary hypertension (2.5 vs. 2.6). For community-acquired illness, no mortality was found in either
congenital heart disease group. When the cohort of
congenital heart disease patients was divided into pre- and postribavirin administration eras, no differences in mean hospital duration, ICU days, and
mechanical ventilation days were noted. Of the 79
congenital heart disease patients, only two died during their hospitalization in which
respiratory syncytial virus infection occurred. Both patients had nosocomial-acquired respiratory syncytial virus and both were from the postribavirin administration cohort. One of these two patients had received
antiviral therapy. Neither death was secondary to respiratory syncytial virus
respiratory failure (based on pathologic examination).
CONCLUSIONS: