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Children with neurological disorders at greater risk for respiratory infections
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Hospitalization rates and death rates related to respiratory infection were higher among children with neurological conditions, compared with children without neurological conditions, according to research in The Journal of Pediatrics.
“Children with neurologic conditions are at greatly increased risk for hospitalization and death due to respiratory infections compared with other children,” Fiona Havers, MD, MHS, of the influenza division at the CDC, and colleagues wrote. “This risk is increased further by the presence of more than one neurologic condition or a severity indicator and certain conditions, such as metabolic diseases, motor neuron diseases, and muscular dystrophy.”
The researchers retrospectively analyzed commercial and Medicaid insurance claims data for 33.6 million children aged younger than 19 with more than one hospital visit with an ICD-9 code for neurological disorder. They then identified patients with a primary diagnosis related to respiratory infection. Data for children with neurological conditions and respiratory infections were compared to a random sample of children from the same insurance claims datasets. Study cohorts were classified as commercial or Medicaid insurance for the comparison and neurological disorder groups.
Study results showed that 12% of hospital visits among children with neurological disorders were related to respiratory infections. These infections included pneumonia and influenza (71%), acute respiratory infection (29%), and bronchitis and bronchiolitis (16%). Repeat infections comprised 29% of respiratory infections among children with neurological disorders.
Havers and colleagues said the children with neurological disorders had a greater risk than controls. Results showed that risk was increased based on whether children were covered by Medicaid (RR = 5; 95% CI, 4.8-5.2) or commercial insurance (RR = 7.4; 95% CI, 7.1-7.7). Specifically, the risk for hospitalization related to respiratory infection was highest among children aged younger than 2 years, while children aged 10 to 18 years were 14.5 times more likely to be hospitalized than aged matched peers (95% CI, 13.3-16.7).
The risk for in-hospital mortality caused by respiratory infection was greater for children with neurological disorders covered by Medicaid (RR = 20; 95% CI, 18.4-21.5) and commercial insurance (RR = 54.7; 95% CI, 52.5-57.9) compared with the comparison.
The researcher suggested that this increased risk may be due to complications unique to children with neurological disorders, such as decreased muscle strength, impaired mobility, diminished pulmonary function and impaired immune function.
“Public health messaging should focus on raising awareness of the risk of respiratory infections in children with neurologic disorders and of interventions that could prevent hospitalizations,” Havers and colleagues wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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