From the Department of Cardiology, University of Oklahoma, Oklahoma.
Department of Biostatistics.
Pediatr Infect Dis J. 2024 Aug 1;43(8):720-724. doi: 10.1097/INF.0000000000004341. Epub 2024 Apr 2.
The aim of the study is to evaluate the mortality risk factors and hospitalization outcomes of adenovirus pneumonia in pediatric patients with congenital heart disease.
In this retrospective multicenter cohort study utilizing the Pediatric Health Information System database, we analyzed congenital heart disease patients with adenovirus pneumonia from January 2004 to September 2018, categorizing them into shunts, obstructive lesions, cyanotic lesions and mixing lesions. Multivariate logistic regression analysis was employed to identify mortality risk factors with 2 distinct models to mitigate collinearity issues and the Mann-Whitney U test was used to compare the hospital length of stay between survivors and nonsurvivors across these variables.
Among 381 patients with a mean age of 3.2 years (range: 0-4 years), we observed an overall mortality rate of 12.1%, with the highest mortality of 15.1% noted in patients with shunts. Model 1 identified independent factors associated with increased mortality, including age 0-30 days (OR: 8.13, 95% CI: 2.57-25.67, P < 0.005), sepsis/shock (OR: 3.34, 95% CI: 1.42-7.83, P = 0.006), acute kidney failure (OR: 4.25, 95% CI: 2.05-13.43, P = 0.0005), shunts (OR: 2.95, 95% CI: 1.14-7.67, P = 0.03) and cardiac catheterization (OR: 6.04, 95% CI: 1.46-24.94, P = 0.01), and Model 2, extracorporeal membrane oxygenation (OR: 3.26, 95% CI: 1.35-7.87, P = 0.008). Nonsurvivors had a median hospital stay of 47 days compared to 15 days for survivors.
The study revealed a 12.1% mortality rate in adenoviral pneumonia among children with congenital heart disease, attributed to risk factors such as neonates, sepsis, acute kidney failure, shunts, cardiac catheterization, extracorporeal membrane oxygenation use and a 3-fold longer hospital stay for nonsurvivors compared to survivors.
本研究旨在评估小儿先天性心脏病合并腺病毒肺炎的死亡风险因素和住院结局。
本回顾性多中心队列研究利用儿科健康信息系统数据库，分析了 2004 年 1 月至 2018 年 9 月期间患有腺病毒肺炎的先天性心脏病患儿，将其分为分流组、梗阻性病变组、紫绀性病变组和混合病变组。采用多变量逻辑回归分析确定死亡风险因素，采用 2 个不同的模型来减轻共线性问题，采用曼-惠特尼 U 检验比较幸存者和非幸存者在这些变量上的住院时间。
在 381 名平均年龄为 3.2 岁（范围：0-4 岁）的患儿中，我们观察到总死亡率为 12.1%，分流组死亡率最高为 15.1%。模型 1 确定了与死亡率增加相关的独立因素，包括 0-30 天龄（OR：8.13，95%CI：2.57-25.67，P＜0.005）、脓毒症/休克（OR：3.34，95%CI：1.42-7.83，P=0.006）、急性肾衰竭（OR：4.25，95%CI：2.05-13.43，P=0.0005）、分流（OR：2.95，95%CI：1.14-7.67，P=0.03）和心导管术（OR：6.04，95%CI：1.46-24.94，P=0.01），模型 2 为体外膜肺氧合（ECMO）（OR：3.26，95%CI：1.35-7.87，P=0.008）。非幸存者的中位住院时间为 47 天，而幸存者为 15 天。
本研究显示，先天性心脏病合并腺病毒肺炎患儿的死亡率为 12.1%，其危险因素包括新生儿、脓毒症、急性肾衰竭、分流、心导管术、体外膜肺氧合（ECMO）的使用，而非幸存者的住院时间比幸存者长 3 倍。
