Add like
Add dislike
Add to saved papers

Pre-existing disease is associated with a significantly higher risk of death in severe respiratory syncytial virus infection.

BACKGROUND: 600,000 deaths worldwide are estimated to be directly or indirectly attributable to respiratory syncytial virus (RSV).

OBJECTIVES: To determine: (1) the mortality rate; and (2) risk factors for death in children with severe RSV infection.

SETTING: 20-bed, regional, multidisciplinary, tertiary, paediatric intensive care unit (PICU) in a university-affiliated children's hospital.

METHODS: Cohort study of all children with severe RSV infection covering eight consecutive RSV seasons (1999-2007), using PICU admission as a marker of severity.

RESULTS: Of the 406 RSV-positive patients that were admitted to PICU: 98.5% required mechanical ventilation; 35 children died--median age 5.1 months (interquartile range (IQR) 2.4-13.6), length of PICU stay 16 days (IQR 8-31) and 371 survived--median age 2.5 months (IQR 1.2-9), length of PICU stay 5 days (IQR 4-9). The overall PICU RSV mortality was 8.6% with a standardised mortality ratio of 0.76. During the study period 2009 RSV-positive patients were admitted to the children's hospital, giving a hospital RSV mortality rate of 1.7%. Of the deaths, 18 were directly RSV related (RSV bronchiolitis-related mortality PICU 4.4% and hospital 0.9%) as the patients were still RSV positive when they died and 17 children died from non-pneumonitis causes after becoming RSV negative. All of the RSV deaths had pre-existing medical conditions--chromosomal abnormalities 29%, cardiac lesions 27%, neuromuscular 15%, chronic lung disease 12%, large airway abnormality 9%, and immunodeficiency 9%. Nineteen children (56%) had pre-existing disease in two or more organ systems (relative risk (RR) 4.38). Predisposing risk factors for death were pre-existing disease (RR 2.36), cardiac anomaly (RR 2.98) and nosocomial/hospital-acquired RSV infection (RR 2.89). There is an interaction effect between pre-existing disease, nosocomial/hospital-acquired RSV infection and mortality (p<0.001).

CONCLUSIONS: Pre-existing disease/comorbidity, in particular multiple pre-existing diseases and cardiac anomaly, is associated with a significantly higher risk of death from severe RSV infection. Nosocomial/hospital-acquired RSV infection is an additional major risk factor for death in children with severe RSV infection.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app