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Risk factors for infective endocarditis in children with congenital heart diseases - A nationwide population-based case control study
- Source :
- International Journal of Cardiology. 248:126-130
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background Infective endocarditis (IE) is uncommon in childhood. Its associated epidemiological characteristics in patients with congenital heart disease (CHD) remain unclear. Methods The study population included children born in Taiwan during the years 1997 to 2005 who were diagnosed as having CHD before 3years of age. All children were followed up until the end year of 2010, the diagnosis of infective endocarditis, or death. The demographic characteristics of patients with and without IE, the invasive procedures performed during 6months before the index date, the prophylactic antibiotics related to dental procedures, and in-hospital mortality were collected. Results Information of 24,729 children with CHD were retrieved for our analysis and 237 patients with newly diagnosed IE were identified. The incidence rate of IE in all CHD lesions was 11.13 per 10,000person-years. Taking ASD for reference, the following CHD lesions were at risk for IE: cyanotic CHD (adjusted OR, 9.58; 95% confidence interval, 5.38–17.05), endocardial cushion defect (ECD) (8.01; 2.73–23.50), Left-sided lesions (4.36; 1.90–10.01) and VSD (2.93; 1.64–5.23). Patients who underwent procedures have a higher risk of acquiring IE which include central venous catheter (CVC) insertion (3.17; 2.36–4.27), cardiac catheterization (3.74; 2.67–5.22), open-heart surgery (2.47; 1.61–3.77), valve surgery (3.20; 1.70–6.02), and shunt surgery (7.43; 2.36–23.41). However, dental procedures did not increase the risk of IE, irrespective of antibiotic usage. Conclusions The risk of IE varies markedly among CHD lesions in our study. Invasive heart procedures but not dental procedures, are more significantly associated with IE among children with CHD.
- Subjects :
- Heart Defects, Congenital
Male
Pediatrics
medicine.medical_specialty
Heart disease
medicine.medical_treatment
Taiwan
030204 cardiovascular system & hematology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Risk Factors
Epidemiology
medicine
Humans
Endocarditis
Hospital Mortality
030212 general & internal medicine
Child
Retrospective Studies
Cardiac catheterization
business.industry
Infant, Newborn
Infant
Retrospective cohort study
medicine.disease
Surgery
Case-Control Studies
Child, Preschool
Population Surveillance
Infective endocarditis
Female
Cardiology and Cardiovascular Medicine
business
Central venous catheter
Follow-Up Studies
Cohort study
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 248
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....86db60454c1f22951e266c1b136f370b