Objective:
Determine the change in respiratory syncytial virus (RSV) hospitalizations for patients with hemodynamically significant congenital heart disease (hs-CHD) following the 2003 AAP policy revision recommending palivizumab prophylaxis.
Methods:
Hospital discharge data from the years 2000 and 2006 were obtained from the Kids’ Inpatient Database (KID). ICD9-DM codes were used to identify RSV admissions among patients less than or equal to 24 months of age with CHD and hs-CHD. Demographic risk factors were assessed between years and logistic regression was performed to compare odds of RSV admission versus non-RSV admission among patients with CHD and hs-CHD patients.
Results:
Among CHD and hs-CHD patients, RSV admissions decreased by 26% (2,688 to 2,649) and 37% (635 to 467) respectively from 2000 to 2006 (p<0.01). Patients with hs-CHD were less likely to be admitted for RSV in 2000 than 2006 (OR=0.70, 95% CI: 0.62-0.78). As opposed to patients with private insurance, those with governmental insurance were more likely to be admitted for RSV among patients with hs-CHD (OR=1.55 (95% CI: 1.28-1.89).
Conclusions:
Nationally representative data demonstrate that RSV admissions among patients with hs-CHD decreased in the palivizumab era. This decrease is temporally related to the release of the 2003 AAP Guidelines and likely represents the clinical impact of prophylaxis. Patients with hs-CHD and governmental insurance remain at higher risk of hospitalization from RSV despite the availability of prophylaxis.