A multicenter outcomes analysis of children with severe viral respiratory infection due to human metapneumovirus

Michael C. Spaeder, Jason W. Custer, Melania Bembea, Devon O. Aganga, Xiaoyan Song, Susanna Scafidi

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the impact of human metapneumovirus on morbidity and mortality outcomes in children with severe viral respiratory infection. Design: Retrospective cohort study. Setting: ICU, either PICU or cardiac ICU, at three urban academic tertiary care children's hospitals. Patients: All patients admitted to an ICU with laboratory-confirmed human metapneumovirus infection between January 2010 and June 2011. Interventions: We captured demographic and clinical data and analyzed associated morbidity and mortality outcomes. Measurements and Main Results: There were 111 patients with laboratory-confirmed human metapneumovirus admitted to an ICU at one of the three participating institutions during the period of study. The median hospital length of stay was 7 days (interquartile range 4-18 days) and median ICU length of stay was 4 days (interquartile range 1-10 days). Ten patients (9%) did not survive to discharge. Predisposing factors associated with increased mortality included female gender (p = 0.002), presence of a chronic medical condition (p = 0.04), and hospital acquisition of human metapneumovirus infection (p = 0.006). Adjusting for female gender, chronic medical conditions, hospital acquisition of infection and severity of illness score, logistic regression analysis demonstrated that female gender, hospital acquisition of infection, and chronic medical conditions each independently increased the odds of mortality (odds ratios 14.8, 10.7, and 12.7, respectively). Conclusions: Analysis of our results suggests that there is substantial morbidity and mortality associated with severe viral respiratory infection due to human metapneumovirus in children. Female gender, hospital acquisition of human metapneumovirus infection, and presence of chronic medical conditions each independently increases mortality. The burden of illness from human metapneumovirus on the ICU in terms of resource utilization may be considerable.

Original languageEnglish (US)
Pages (from-to)268-272
Number of pages5
JournalPediatric Critical Care Medicine
Volume14
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Metapneumovirus
Virus Diseases
Respiratory Tract Infections
Mortality
Length of Stay
Cross Infection
Morbidity
Infection
Cost of Illness
Tertiary Healthcare
Causality
Cohort Studies
Retrospective Studies
Logistic Models
Odds Ratio
Regression Analysis
Demography

Keywords

  • child
  • human metapneumovirus
  • intensive care
  • outcomes research
  • pediatrics
  • respiratory tract infections

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

A multicenter outcomes analysis of children with severe viral respiratory infection due to human metapneumovirus. / Spaeder, Michael C.; Custer, Jason W.; Bembea, Melania; Aganga, Devon O.; Song, Xiaoyan; Scafidi, Susanna.

In: Pediatric Critical Care Medicine, Vol. 14, No. 3, 03.2013, p. 268-272.

Research output: Contribution to journalArticle

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abstract = "Objective: To investigate the impact of human metapneumovirus on morbidity and mortality outcomes in children with severe viral respiratory infection. Design: Retrospective cohort study. Setting: ICU, either PICU or cardiac ICU, at three urban academic tertiary care children's hospitals. Patients: All patients admitted to an ICU with laboratory-confirmed human metapneumovirus infection between January 2010 and June 2011. Interventions: We captured demographic and clinical data and analyzed associated morbidity and mortality outcomes. Measurements and Main Results: There were 111 patients with laboratory-confirmed human metapneumovirus admitted to an ICU at one of the three participating institutions during the period of study. The median hospital length of stay was 7 days (interquartile range 4-18 days) and median ICU length of stay was 4 days (interquartile range 1-10 days). Ten patients (9{\%}) did not survive to discharge. Predisposing factors associated with increased mortality included female gender (p = 0.002), presence of a chronic medical condition (p = 0.04), and hospital acquisition of human metapneumovirus infection (p = 0.006). Adjusting for female gender, chronic medical conditions, hospital acquisition of infection and severity of illness score, logistic regression analysis demonstrated that female gender, hospital acquisition of infection, and chronic medical conditions each independently increased the odds of mortality (odds ratios 14.8, 10.7, and 12.7, respectively). Conclusions: Analysis of our results suggests that there is substantial morbidity and mortality associated with severe viral respiratory infection due to human metapneumovirus in children. Female gender, hospital acquisition of human metapneumovirus infection, and presence of chronic medical conditions each independently increases mortality. The burden of illness from human metapneumovirus on the ICU in terms of resource utilization may be considerable.",
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N2 - Objective: To investigate the impact of human metapneumovirus on morbidity and mortality outcomes in children with severe viral respiratory infection. Design: Retrospective cohort study. Setting: ICU, either PICU or cardiac ICU, at three urban academic tertiary care children's hospitals. Patients: All patients admitted to an ICU with laboratory-confirmed human metapneumovirus infection between January 2010 and June 2011. Interventions: We captured demographic and clinical data and analyzed associated morbidity and mortality outcomes. Measurements and Main Results: There were 111 patients with laboratory-confirmed human metapneumovirus admitted to an ICU at one of the three participating institutions during the period of study. The median hospital length of stay was 7 days (interquartile range 4-18 days) and median ICU length of stay was 4 days (interquartile range 1-10 days). Ten patients (9%) did not survive to discharge. Predisposing factors associated with increased mortality included female gender (p = 0.002), presence of a chronic medical condition (p = 0.04), and hospital acquisition of human metapneumovirus infection (p = 0.006). Adjusting for female gender, chronic medical conditions, hospital acquisition of infection and severity of illness score, logistic regression analysis demonstrated that female gender, hospital acquisition of infection, and chronic medical conditions each independently increased the odds of mortality (odds ratios 14.8, 10.7, and 12.7, respectively). Conclusions: Analysis of our results suggests that there is substantial morbidity and mortality associated with severe viral respiratory infection due to human metapneumovirus in children. Female gender, hospital acquisition of human metapneumovirus infection, and presence of chronic medical conditions each independently increases mortality. The burden of illness from human metapneumovirus on the ICU in terms of resource utilization may be considerable.

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