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Sung M, Kim JH, Ha EK, Shin J, Kwak JH, Jee HM, Han MY. Population-based retrospective cohort study on community-acquired pneumonia hospitalization in children with a ventricular septal defect. Sci Rep 2024; 14:9307. [PMID: 38654012 PMCID: PMC11039453 DOI: 10.1038/s41598-024-59510-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
The cohort consisted of 9400 exposed children diagnosed with ventricular septal defect (VSD). The risk of community-acquired pneumonia (CAP) or asthma with VSD was assessed using the Cox proportional hazard model with an inverse probability of treatment weighting. During a mean follow-up of 6.67 years (starting from 12 months after birth), there were 2100 CAP admission cases among exposed patients (incidence rate: 33.2 per 1000 person-years) and 20,109 CAP admission cases among unexposed children (incidence rate: 29.6 per 1000 person-years), with hazard ration of 1.09 (95% CI 1.04-1.14).
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Affiliation(s)
- Myongsoon Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea
- Department of Pediatrics, National Jewish Health, Denver, CO, USA
| | - Ju Hee Kim
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jeewon Shin
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, 351 Yatap-Dong, Bundang-Gu, Seongnam, 463-712, Gyonggi-Do, Korea
| | - Ji Hee Kwak
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Mi Jee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, 351 Yatap-Dong, Bundang-Gu, Seongnam, 463-712, Gyonggi-Do, Korea.
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, 351 Yatap-Dong, Bundang-Gu, Seongnam, 463-712, Gyonggi-Do, Korea.
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Divin N, Given JE, Tan J, Astolfi G, Ballardini E, Barrachina-Bonet L, Cavero-Carbonell C, Coi A, Garne E, Gissler M, Heino A, Jordan S, Pierini A, Scanlon I, Urhøj SK, Morris JK, Loane M. Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study. BMJ Open 2023; 13:e068885. [PMID: 37832979 PMCID: PMC10583066 DOI: 10.1136/bmjopen-2022-068885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVES To explore the risk of being prescribed/dispensed medications for respiratory symptoms and breathing difficulties in children with and without congenital anomalies. DESIGN A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies were linked to prescription databases to identify children who did/did not receive antiasthmatic prescriptions. Data were analysed by age, European region, class of antiasthmatic, anomaly, sex, gestational age and birth cohort. SETTING Children born 2000-2014 in six regions within five European countries. PARTICIPANTS 60 662 children with congenital anomalies and 1 722 912 reference children up to age 10 years. PRIMARY OUTCOME MEASURE Relative risks (RR) of >1 antiasthmatic prescription in a year, identified using Anatomical Therapeutic Chemical classification codes beginning with R03. RESULTS There were significant differences in the prescribing of antiasthmatics in the six regions. Children with congenital anomalies had a significantly higher risk of being prescribed antiasthmatics (RR 1.41, 95% CI 1.35 to 1.48) compared with reference children. The increased risk was consistent across all regions and all age groups. Children with congenital anomalies were more likely to be prescribed beta-2 agonists (RR 1.71, 95% CI 1.60 to 1.83) and inhaled corticosteroids (RR 1.74, 95% CI 1.61 to 1.87). Children with oesophageal atresia, genetic syndromes and chromosomal anomalies had over twice the risk of being prescribed antiasthmatics compared with reference children. Children with congenital anomalies born <32 weeks gestational age were over twice as likely to be prescribed antiasthmatics than those born at term (RR 2.20, 95% CI 2.10 to 2.30). CONCLUSION This study documents the additional burden of respiratory symptoms and breathing difficulties for children with congenital anomalies, particularly those born preterm, compared with children without congenital anomalies in the first 10 years of life. These findings are beneficial to clinicians and healthcare providers as they identify children with greater morbidity associated with respiratory symptoms, as indicated by antiasthmatic prescriptions.
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Affiliation(s)
- Natalie Divin
- Institute of Nursing and Health Research, Faculty of Life and Health Sciences,Ulster University, Belfast, UK
| | - Joanne Emma Given
- Institute of Nursing and Health Research, Faculty of Life and Health Sciences,Ulster University, Belfast, UK
| | - Joachim Tan
- Population Health Research Institute, St George's University of London, London, UK
| | - Gianni Astolfi
- Emilia Romagna Registry of Birth Defects, University of Ferrara, Ferrara, Italy
| | - Elisa Ballardini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Laia Barrachina-Bonet
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian region, Valencia, Spain
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian region, Valencia, Spain
| | - Alessio Coi
- Institute of Clinical Physiology, National Research Council Pisa Research Area, Pisa, Italy
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Mika Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anna Heino
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Susan Jordan
- Department of Nursing, Swansea University, Swansea, UK
| | - Anna Pierini
- Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Ieuan Scanlon
- Department of Nursing, Swansea University, Swansea, UK
| | - Stine Kjær Urhøj
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Joan K Morris
- Population Health Research Institute, St George's University of London, London, UK
| | - Maria Loane
- Institute of Nursing and Health Research, Faculty of Life and Health Sciences,Ulster University, Belfast, UK
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Singhi AK, Mahapatra SK, Kumar D, Dey S, Mishra A, De A. Challenges in Device Closure of Secundum Atrial Septal Defect in Older Patients in Their Fifth Decade and Beyond. Cureus 2022; 14:e22480. [PMID: 35223335 PMCID: PMC8861837 DOI: 10.7759/cureus.22480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Abstract
Objective Transcatheter atrial septal defect (ASD) device closure in the older population presents a greater challenge due to the long-standing effect of atrial left-to-right shunt. This study analyzes the challenges encountered in transcatheter ASD device closure in older patients in their fifth decade and beyond. Methods Adults aged 40 years and above with significant secundum ASD who underwent transcatheter ASD device closure between June 2015 and April 2021 were analyzed. Challenges were classified as major and minor challenges based on their impact on the alteration of the treatment protocol. Patients were categorized into three subgroups according to age. Group 1 consisted of patients aged 40-49 years (n = 13), Group 2 consisted of patients aged 50-59 years (n = 16), and Group 3 consisted of patients aged 60 years and above (n = 8). Results A total of 37 patients were analyzed. The challenges encountered were arrhythmia, pulmonary hypertension, left ventricular diastolic dysfunction, bleeding, stroke, coronary artery disease (CAD), hypertension, and airway disease. Thirteen percent of challenges were seen in pre-procedure time, whereas 79% of challenges during the procedure and 8% of challenges during post-procedure were seen. Thirty-five patients (94.6%) underwent transcatheter ASD device closure. Two patients (5.4%) did not undergo transcatheter ASD device closure due to severe diastolic dysfunction and associated CAD, respectively. Eleven major challenges were encountered in 10 patients in which one patient had a dual challenge of bleeding and arrhythmia. Thirteen patients (35.1%) had smooth procedures without any challenges encountered. Twenty-seven minor challenges were encountered in 20 patients with some patients having an overlap of multiple major and minor challenges. The patients were doing well at the mean follow-up of 28 months. Conclusions Transcatheter ASD device closure in older patients who are 40 years and above is safe and effective. Such high-risk patients are prone to various challenges that can be effectively managed if optimally monitored on the basis of a proper understanding of the altered physiology and anticipation of the deviated course at various stages of the procedure.
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Guerin S, Bertille N, Khraiche D, Bonnet D, Lebourgeois M, Goffinet F, Lelong N, Khoshnood B, Delacourt C. Respiratory morbidity in children with congenital heart disease. Arch Pediatr 2021; 28:525-529. [PMID: 34497013 DOI: 10.1016/j.arcped.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/06/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the respiratory outcome in children with congenital heart disease (CHD), considering recent management procedures and the CHD pathophysiology. DESIGN AND SETTING Clinical and functional respiratory outcome were evaluated in 8-year-old children with isolated CHD followed up from birth in the prospective population-based EPICARD cohort. PATIENTS Children were assigned to two groups, based on the pathophysiology of the CHD: CHDs with left-to-right shunt (n = 212) and CHDs with right outflow tract obstruction (n = 113). RESULTS Current wheezing episodes were observed in 15% of the children with isolated CHD and left-to-right shunt, and 11% of the children with isolated CHD and right outflow tract obstruction (not significant). Total lung capacity (TLC) was the only respiratory function parameter that significantly differed between the two groups. It was lower in children with left-to-right shunt (88.72 ± 0.65% predicted) than in those with right outflow tract obstruction (91.84 ± 0.96, p = 0.006). In multivariate analysis, CHD with left-to-right shunt (coeff. [95% CI]: -3.17 [-5.45; -0.89]) and surgery before the age of 2 months (-6.52 [-10.90; -2.15]) were identified as independent factors associated with significantly lower TLC values. CONCLUSION Lower TLC remains a long-term complication in CHD, particularly in cases with left-to-right shunt and in patients requiring early repair. These findings suggest that an increase in pulmonary blood flow may directly impair lung development.
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Affiliation(s)
- S Guerin
- Pediatric Pulmonology, Centre de référence des Maladies Respiratoires Rares - RESPIRARE, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, 75015 Paris, France; Current address for Sophie GUERIN: Unité de pneumologie pédiatrique - Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
| | - N Bertille
- INSERM UMR 1153, Obstetric, Perinatal and Pediatric Epidemiology Research Team (Epopé) Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), 75014 Paris, France
| | - D Khraiche
- Pediatric Cardiology, Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, 75015 Paris, France
| | - D Bonnet
- Pediatric Cardiology, Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, 75015 Paris, France; Paris-Descartes University, University of Paris, Faculty of Medicine, 75006 Paris, France
| | - M Lebourgeois
- Pediatric Pulmonology, Centre de référence des Maladies Respiratoires Rares - RESPIRARE, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, 75015 Paris, France
| | - F Goffinet
- INSERM UMR 1153, Obstetric, Perinatal and Pediatric Epidemiology Research Team (Epopé) Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), 75014 Paris, France; Paris-Descartes University, University of Paris, Faculty of Medicine, 75006 Paris, France
| | - N Lelong
- INSERM UMR 1153, Obstetric, Perinatal and Pediatric Epidemiology Research Team (Epopé) Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), 75014 Paris, France
| | - B Khoshnood
- INSERM UMR 1153, Obstetric, Perinatal and Pediatric Epidemiology Research Team (Epopé) Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), 75014 Paris, France
| | - C Delacourt
- Pediatric Pulmonology, Centre de référence des Maladies Respiratoires Rares - RESPIRARE, Necker Hospital for Sick Children, Assistance Publique des Hôpitaux de Paris, 75015 Paris, France; Paris-Descartes University, University of Paris, Faculty of Medicine, 75006 Paris, France
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Feng BW, He CY, Liu XQ, Chen YS, He SR. Effect of congenital heart disease on the recurrence of cough variant asthma in children. BMC Cardiovasc Disord 2021; 21:130. [PMID: 33691639 PMCID: PMC7949247 DOI: 10.1186/s12872-021-01940-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background The research into the recurrence of cough variant asthma (CVA) in congenital heart disease (CHD) are few in number. The purpose of this study is to investigate the effect of CHD on the risk of the recurrence of CVA. Methods This study was a retrospective cohort study of 489 children with CVA aged between one and 14 years, of whom 67 had CHD complicated with CVA and 134 had CVA without CHD at a ratio of 1:2 according to age, sex and index year. The adjusted hazard ratio (aHR) of CVA recurrence in both the CHD cohort and the non-CHD cohort was determined by multivariate analysis using the Cox proportional hazard regression model. Results Adjusting for CHD classification, Mycoplasma pneumonia (MP) infection and immunoglobulin E (IgE) sensitization, the recurrence hazard of CVA in the complex congenital heart disease (CCHD) group (aHR = 3.281; 95% CI 1.648–6.530; P < 0.01) was significantly higher than that in the simple congenital heart disease group (aHR = 2.555; 95% CI 1.739–3.752; P < 0.01). Further, children with IgE sensitization (aHR = 2.172; 95% CI 1.482–3.184; P < 0.01) had a higher recurrence hazard of CVA than those without IgE sensitization, and children with MP infection (aHR = 1.777; 95% CI 1.188–2.657; P < 0.01) had a higher recurrence hazard of CVA than those without the MP infection. Conclusion The hazard of recurrent CVA is higher in children with CHD, especially in the CCHD children. In addition, those children with IgE sensitization or a MP infection had an increased hazard of recurrent CVA.
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Affiliation(s)
- B W Feng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Neonatology of Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - C Y He
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Neonatology of Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - X Q Liu
- Department of Epidemiology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
| | - Y S Chen
- Department of Neonatology of Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - S R He
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Neonatology of Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China. .,Department of Pediatrics of Guangdong Provincial People's Hospital, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China.
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Nassif M, Woudstra OI, Kuijpers JM, Sterk PJ, van Steenwijk RP, Zwinderman AH, Bouma BJ, Mulder BJ, de Winter RJ. Use of Pulmonary Inhalants Remains Remarkably High After Atrial Septal Defect Closure. Circ J 2018; 82:2913-2916. [PMID: 30298834 DOI: 10.1253/circj.cj-18-0613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Post-repair atrial septal defects (ASD) patients are frequently discharged from follow-up, but the extent of pulmonary symptoms long-term post-repair is unknown. Methods and Results: The national CONgenital CORvitia registry was linked to the national Drug Registry to investigate all ambulatory-dispensed pulmonary inhalants for 2006-2014. ASD patients were compared with age- and sex-matched referents from the general population. A total of 1,959 adult patients (age 42±17 years; 66% female; 1,223 [62%] repaired) were included. Compared with the referents, ASD patients had more inhalant use, even at long-term post-repair follow-up (OR=1.81 [95% CI 1.62-2.03]; P<0.001). CONCLUSIONS ASD patients had 2-fold higher inhalant use compared with referents even at long-term post-repair follow-up, suggesting persistent pulmonary functional impairment.
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Affiliation(s)
| | - Odilia I Woudstra
- Department of Cardiology, Academic Medical Center.,Department of Cardiology, University Medical Center Utrecht
| | - Joey M Kuijpers
- Department of Cardiology, Academic Medical Center.,Netherlands Heart Institute
| | - Peter J Sterk
- Department of Respiratory Medicine, Academic Medical Center
| | | | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center
| | | | - Barbara J Mulder
- Department of Cardiology, Academic Medical Center.,Netherlands Heart Institute
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