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HF increases risk for in-hospital death in children with muscular dystrophy
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ORLANDO, Fla. — HF-related hospitalizations are increasingly observed as children with muscular dystrophy approach adulthood, and these hospitalizations are associated with a threefold increase in the risk for in-hospital death.
“[These new data] highlight that further study is needed to improve the care of this complex group of patients,” Joseph W. Rossano, MD, MS, FAAP, FAAC, of The Children’s Hospital Philadelphia, said at the Annual Scientific Meeting of the Heart Failure Society of America.
Joseph W. Rossano
The researchers conducted a retrospective review of records from the Health Care Cost and Utilization Project Kids Inpatient Database (2000, 2003, 2006, 2009). They evaluated data on patients aged 20 years or younger who were diagnosed with muscular dystrophy and/or HF.
The unadjusted in-hospital mortality rate for pediatric muscular dystrophy patients was 12.7% for HF-related hospitalizations and 2.9% for non–HF-related hospitalizations (OR=4.8; 95% CI, 3.5-6.6). After controlling for age, year and comorbidities, the researchers found that HF was independently associated with in-hospital mortality in these patients (adjusted OR=3.3; 95% CI, 2.3-4.9), Rossano said.
The rate of HF-related hospitalizations increased as children aged: 1.2% for age ≤10 years; 7.2% for age 11 to 15 years; 11.6% for age 16 to 20 years (P<.001).
Overall, HF was identified in 6.4% of hospitalizations of children with muscular dystrophy, and this rate did not change with time, according to Rossano.
In a multivariable analysis, age was not associated with mortality. “It appears that [the rate of mortality] is high irrespective of age,” he said.
Compared with non–HF-related hospitalizations, children hospitalized for HF were more likely to have sepsis (6% vs. 3.8%; OR=1.6; 95% CI, 1.1-2.4), respiratory failure (28.8% vs. 19.3%; OR=1.7; 95% CI, 1.3-2.1), acute renal failure (3.8% vs. 0.5%; OR=7.9; 95% CI, 4.4-14.3), arrhythmias (22.8% vs. 8%; OR=3.4; 95% CI, 2.6-4.3) and pulmonary hypertension (4.7% vs. 0.8%; OR=6.4; 95% CI, 9.5-12.5). – by Erik Swain
For more information:
Rossano JW. Abstract #112. Presented at: the Annual Scientific Meeting of the Heart Failure Society of America; Sept. 22-25, 2013; Orlando, Fla.
Disclosure: Rossano reports no relevant financial disclosures.