Burden of Influenza-Related Hospitalizations Among Children With Sickle Cell Disease
- 1 February 2010
- journal article
- Published by American Academy of Pediatrics (AAP)
- Vol. 125 (2), 234-243
- https://doi.org/10.1542/peds.2009-1465
Abstract
OBJECTIVE: Children with sickle cell disease (SCD) are considered to be at high risk for complications from influenza infection despite minimal published data that characterize the burden of influenza in this population. Our objectives were to (1) estimate the rate of influenza-related hospitalizations (IRHs) among children with SCD, (2) compare this rate with rates of children with cystic fibrosis (CF) and children with neither SCD nor CF, and (3) explore mechanisms that underlie these potentially preventable hospitalizations. METHODS: We analyzed hospitalizations from 4 states (California, Florida, Maryland, and New York) across 2 influenza seasons (2003–2004 and 2004–2005) from the Healthcare Cost and Utilization Project State Inpatient Databases. We included hospitalizations with a discharge diagnosis code for influenza in a child <18 years of age. We used census data and disease prevalence estimates to calculate denominators and compare rates of IRH among children with SCD, CF, and neither disease. RESULTS: There were 7896 pediatric IRHs during the 2 influenza seasons. Of these, 159 (2.0%) included a co-occurring diagnosis of SCD. Annual rates of IRHs were 112 and 2.0 per 10 000 children with and without SCD, respectively, across both seasons. Children with SCD were hospitalized with influenza at 56 times (95% confidence interval: 48–65) the rate of children without SCD. Children with SCD had approximately double the risk of IRH compared with children with CF (risk ratio: 2.1 [95% confidence interval: 1.5–2.9]). IRHs among children with SCD were not longer, more costly, or more severe than IRHs among children without SCD; they were also rarely nosocomial and co-occurred with a diagnosis of asthma in 14% of cases. CONCLUSIONS: IRHs are substantially more common among children with SCD than among those without the disease, which supports the potential importance of vigorous influenza vaccination efforts that target children with SCD.Keywords
This publication has 43 references indexed in Scilit:
- Estimating Influenza Hospitalizations among ChildrenEmerging Infectious Diseases, 2012
- Models of Comprehensive Multidisciplinary Care for Individuals in the United States With Genetic DisordersPublished by American Academy of Pediatrics (AAP) ,2009
- Prevention of Influenza: Recommendations for Influenza Immunization of Children, 2008–2009Published by American Academy of Pediatrics (AAP) ,2008
- Influenza Vaccination in Adolescents With High-Risk ConditionsPublished by American Academy of Pediatrics (AAP) ,2008
- Vaccines for preventing influenza in healthy childrenPublished by Wiley ,2008
- Estimating the undetected burden of influenza hospitalizations in childrenEpidemiology and Infection, 2006
- ICD-9 Codes for Identifying Influenza Hospitalizations in ChildrenEmerging Infectious Diseases, 2006
- Sickle Cell Disease: A Question of Equity and QualityPublished by American Academy of Pediatrics (AAP) ,2006
- Influenza-Associated Hospitalizations in the United StatesJAMA, 2004
- Serologic and clinical response of children with sickle cell disease to bivalent influenza A split virus vaccineThe Journal of Pediatrics, 1978