Effects of Palivizumab Guideline Changes on RSV Admissions in Patients with Congenital Heart Disease and Prematurity

• 作者: John Pham Stephen Nageotte Jon Detterich Grace Kung
• 来源期刊: 心血管病(英文)
• 学科: 医学
• 关键词: 2014 American Academy of Pediatrics Children Congenital Heart Disease Guidelines Infants PALIVIZUMAB PREMATURITY Respiratory Syncytial Virus
• 年，卷（期）: 2021,（1）
• 页码范围: 34-44
• 页数: 11页
• 分类号: R97

摘要

<strong>Background:</strong><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Respiratory syncytial virus (RSV) causes significant morbidity and mortality in patients with a history of prematurity and congenital heart disease (CHD). In 2014, the guidelines for Palivizumab became more restrictive for this population. We hypothesized the percentage of RSV+ admissions would increase overall and in this target group (TG) specifically.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We conducted a retrospective review of patients under age 2 years admitted with bronchiolitis two seasons prior to the change (Pre) and two seasons after (Post). Our TG included patients who were eligible prior to the 2014 changes but currently no longer eligible. We used chi-square analysis to answer the two main hypotheses: 1</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> Percent RSV+/total bronchiolitis Pre vs Post and 2</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;"> Percent of TG/RSV+ Pre vs Post.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 1283 patients (546 pre, 737 post) were admitted with the diagnosis of RSV between 2012-2016, 866 actually tested positive for RSV (367 Pre, 499 Post). There was no significant difference in the number of total patients admitted with RSV (Pre = 67.2%, Post = 67.7%) or in our TG (Pre 7.1% vs Post 8.2%). TG overall had a more complicated course: longer length of stay, median 5 days, IQR 2</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">12 vs 3 days, IQR 1</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span