Katherine E Bates1, Matthew Hall2, Samir S Shah3, Kevin D Hill4, Sara K Pasquali1. 1. 1Congenital Heart Center,C.S. Mott Children's Hospital,University of Michigan Medical School,Ann Arbor,Michigan,United States of America. 2. 2Children's Hospital Association,Overland Park,Kansas,United States of America. 3. 3Division of Hospital Medicine and Division of Infectious Diseases,Cincinnati Children's Hospital Medical Center,Cincinnati,Ohio,United States of America. 4. 4Duke University Medical Center and the Duke Clinical Research Institute,Durham,North Carolina,United States of America.
Abstract
OBJECTIVE: National organisations in several countries have recently released more restrictive guidelines for infective endocarditis prophylaxis, including the American Heart Association 2007 guidelines. Initial studies demonstrated no change in infective endocarditis rates over time; however, a recent United Kingdom study suggested an increase; current paediatric trends are unknown. METHODS: Children (5 years of age. Interrupted time series analysis was used to evaluate rates over time indexed to total hospitalisations. RESULTS: A total of 841 cases were identified. The median age was 13 years (interquartile range 9-15 years). In the pre-guideline period, there was a slight increase in the rate of infective endocarditis by 0.13 cases/10,000 hospitalisations per semi-annual period. In the post-guideline period, the rate of infective endocarditis increased by 0.12 cases/10,000 hospitalisations per semi-annual period. There was no significant difference in the rate of change in the pre- versus post-guidelines period (p=0.895). Secondary analyses in children >5 years of age with CHD and in children hospitalised with any type of infective endocarditis at any age revealed similar results. CONCLUSIONS: We found no significant change in infective endocarditis hospitalisation rates associated with revised prophylaxis guidelines over 11 years across 29 United States children's hospitals.
OBJECTIVE: National organisations in several countries have recently released more restrictive guidelines for infective endocarditis prophylaxis, including the American Heart Association 2007 guidelines. Initial studies demonstrated no change in infective endocarditis rates over time; however, a recent United Kingdom study suggested an increase; current paediatric trends are unknown. METHODS:Children (5 years of age. Interrupted time series analysis was used to evaluate rates over time indexed to total hospitalisations. RESULTS: A total of 841 cases were identified. The median age was 13 years (interquartile range 9-15 years). In the pre-guideline period, there was a slight increase in the rate of infective endocarditis by 0.13 cases/10,000 hospitalisations per semi-annual period. In the post-guideline period, the rate of infective endocarditis increased by 0.12 cases/10,000 hospitalisations per semi-annual period. There was no significant difference in the rate of change in the pre- versus post-guidelines period (p=0.895). Secondary analyses in children >5 years of age with CHD and in children hospitalised with any type of infective endocarditis at any age revealed similar results. CONCLUSIONS: We found no significant change in infective endocarditis hospitalisation rates associated with revised prophylaxis guidelines over 11 years across 29 United States children's hospitals.
Authors: Nicola Fawcett; Bernadette Young; Leon Peto; T Phuong Quan; Richard Gillott; Jianhua Wu; Chris Middlemass; Sheila Weston; Derrick W Crook; Tim E A Peto; Berit Muller-Pebody; Alan P Johnson; A Sarah Walker; Jonathan A T Sandoe Journal: BMC Med Date: 2019-09-04 Impact factor: 8.775
Authors: Michael L Williams; Mathew P Doyle; Nicholas McNamara; Daniel Tardo; Manish Mathew; Benjamin Robinson Journal: Ther Adv Cardiovasc Dis Date: 2021 Jan-Dec