Characteristics and Outcomes of Heart Failure–Related Intensive Care Unit Admissions in Children With Cardiomyopathy

• Published in: Journal of cardiac failure Vol. 19; no. 10; pp. 672 - 677
• Main Authors: Shamszad, Pirouz, MD, Hall, Matthew, PhD, Rossano, Joseph W., MD, Denfield, Susan W., MD, Knudson, Jarrod D., MD, PhD, Penny, Daniel J., MD, PhD, Towbin, Jeffrey A., MD, Cabrera, Antonio G., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2013
• Subjects: Adolescent; Cardiomyopathies - diagnosis; Cardiomyopathies - epidemiology; Cardiomyopathies - therapy; Cardiovascular; Child; Child, Preschool; Databases, Factual; Female; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - therapy; Humans; Infant; Infant, Newborn; inpatient; Intensive Care Units - trends; Male; mortality; Patient Admission - trends; Pediatrics; Treatment Outcome; mortality; Pediatrics; inpatient
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2013.08.006

Abstract Objective The purpose of this study was to describe patient characteristics and outcomes of heart failure (HF)–related intensive care unit (ICU) hospitalizations in children with cardiomyopathy (CM). Methods and Results A query of the Pediatric Health Information System database, a large administrative and billing database of 43 tertiary children’s hospitals, was performed. A total of 17,309 HF-related ICU hospitalizations from 2005 to 2010 of 14,985 children ≤18 years old were analyzed. Of those, 2,058 (12%) hospitalizations for CM-HF in 1,599 (11%) children were identified. Classification into CM subtypes was not possible owing to database limitations. The number of yearly CM-HF hospitalizations significantly increased during the study period ( P  = .036). Overall mortality was 11%, and cardiac transplantation occurred in 20% of hospitalizations. Mechanical circulatory support (MCS) was used in 261 (13%) of hospitalizations. Renal failure, MCS, respiratory failure, sepsis, and vasoactive medications were associated with mortality on multivariable analysis. Significant comorbidities associated with these hospitalizations included arrhythmias in 42%, renal failure in 13%, cerebrovascular disease in 6%, and hepatic impairment in 5%. Conclusions HF-related ICU hospitalizations in children with cardiomyopathy are increasing. These children are at high risk for poor outcomes with an in-hospital mortality of 11%.