Hospitalized Children With Encephalitis in the United States: A Pediatric Health Information System Database Study

Bagdure, Dayanand; Custer, Jason W.; Rao, Suchitra; Messacar, Kevin; Dominguez, Samuel R.; Beam, Brandon; Bhutta, Adnan T.

doi:10.1016/j.pediatrneurol.2016.04.014

Cited by 27 publications

(24 citation statements)

References 19 publications

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“…Overall, there were 7.3 encephalitis cases per 100,000 person years in the US during 2000–2010 9 with peak incidence in infants <1 year (13.5 per 100,000) and lowest in children 10–14 years (4.1 per 100,000) 9 . 7298 hospital admissions for encephalitis amongst the 44 free standing children’s hospitals in the Pediatric Health Information System network in the US occurred from 2004–2013 (mean 18 per hospital annually) 10 .…”

Section: Epidemiologymentioning

confidence: 99%

Encephalitis in US Children

Messacar

Fischer

Dominguez

et al. 2018

Infectious Disease Clinics of North America

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Encephalitis is an uncommon but severe disease characterized by neurologic dysfunction with central nervous system inflammation. Children with encephalitis should receive supportive care and empiric therapies for common and treatable causes while prioritizing diagnostic evaluation for common, treatable, and high-risk conditions. Even with an extensive diagnostic workup, an infectious cause is identified in less than half of cases, suggesting a role for postinfectious or noninfectious processes.

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Section: Epidemiologymentioning

confidence: 99%

Encephalitis in US Children

Messacar

Fischer

Dominguez

et al. 2018

Infectious Disease Clinics of North America

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“…De-identified data are submitted by the hospitals and after a thorough reliability and validity check included into the database. 7,8 Patients less than 18 years of age who underwent cardiac surgery were included. Risk Adjustment for Congenital Heart Surgery was utilized to determine procedure complexity.…”

Section: Methodsmentioning

confidence: 99%

Characteristics and outcomes of children with congenital heart disease needing diaphragm plication

et al. 2019

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Background:Diaphragm dysfunction following surgery for congenital heart disease is a known complication leading to delays in recovery and increased post-operative morbidity and mortality. We aimed to determine the incidence of and risk factors associated with diaphragm plication in children undergoing cardiac surgery and evaluate timing to repair and effects on hospital cost and length of stay.Methods:We conducted a multi-institutional retrospective observational cohort study. Forty-three hospitals from the Pediatric Health Information System database were included, and a total of 112,110 patients admitted between January 2004 and December 2014 were analysed.Results:Patients less than 18 years of age who underwent cardiac surgery were included. Risk Adjustment for Congenital Heart Surgery was utilized to determine procedure complexity. The overall incidence of diaphragm dysfunction was 2.2% (n = 2513 out of 112,110). Of these, 24.0% (603 patients) underwent diaphragm plication. Higher complexity cardiac surgery (Risk Adjustment for Congenital Heart Surgery 5–6) and age less than 4 weeks were associated with a higher likelihood of diaphragm plication (p-value < 0.01). Diaphragmatic plication was associated with increased hospital length of stay (p-value < 0.01) and increased medical cost.Conclusions:Diaphragm plication after surgery for congenital heart disease is associated with longer hospital length of stay and increased cost. There is a strong correlation of prolonged time to plication with increased length of stay and medical cost. The likelihood of plication increases with younger age and higher procedure complexity. Methods to improve early recognition and treatment of diaphragm dysfunction should be developed.

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“…The condition is characterised by brain tissue inflammation, resulting from a range of infections and immune-mediated processes [3]. At illness onset, there is usually severe deterioration in the physical and mental functioning of those affected, with between 40–52% of paediatric patients requiring intensive care unit (ICU) admission [4–6]. Symptoms include: altered level of consciousness or abnormal behaviour, fever, vomiting, seizures, communication difficulties, limb weakness and headache [1, 4].…”

Section: Introductionmentioning

confidence: 99%

“…Although mortality from paediatric encephalitis has decreased over past decades to <4% in high resource settings, recovery is highly variable [6, 7]. Follow-up studies have reported persisting sequelae in 42–63% of children, which include seizures, motor weakness, developmental delay, reduced intelligence quotient (IQ), vision and hearing problems [4, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

Understanding parental perspectives on outcomes following paediatric encephalitis: A qualitative study

et al. 2019

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BackgroundEncephalitis, characterised as inflammation of the brain tissue, is an important cause of acquired brain injury in children. Objective clinical outcomes vary significantly between affected patients, however they do not always correlate with quality of life as reported by parents. The aim of this study was to explore how parents experience and interpret outcomes in relation to their child who has been affected by encephalitis.MethodsData were derived from in-depth, semi-structured interviews, with 15 parents of 12 children and young people affected by encephalitis. Paediatric cases were identified from the retrospective arm of the research programme ‘ENCEPH-UK-Understanding and Improving the Outcome of Encephalitis’, and from the prospective UK childhood meningitis and encephalitis cohort study (UK-ChiMES, 2012 to 2016). Data were analysed thematically.ResultsParents’ perspectives on important outcomes for their child and family changed during the different stages of the encephalitis illness trajectory: from acute illness, recovery and rehabilitation, then reintegration into everyday life. Parents’ understanding of their children’s overall outcome was informed by their own experiences, involving comparisons with other children and reflections on their child’s problems before, during and after the acute illness.ConclusionOutcomes in paediatric encephalitis need to be understood in terms of the context of the patient and family experience as well as the timeframe of recovery. The research highlights the need to include more patient, parent and/or carer reported outcome measures during patient assessment, and that assessment should be repeated during recovery as family concerns change. In the longer term, these parameters could be included in clinical and rehabilitation practice to further support child recovery.

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Hospitalized Children With Encephalitis in the United States: A Pediatric Health Information System Database Study

Cited by 27 publications

References 19 publications

Encephalitis in US Children

Encephalitis in US Children

Characteristics and outcomes of children with congenital heart disease needing diaphragm plication

Understanding parental perspectives on outcomes following paediatric encephalitis: A qualitative study

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