Hospital Outcomes Among Children With Congenital Heart Disease and Adenovirus Pneumonia

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.