Published online August 31, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. 503-508 (doi:10.1542/peds.2006-3606)
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ARTICLE

Characteristics of Children Discharged From Hospitals in the United States in 2000 With the Diagnosis of Acute Rheumatic Fever

Christina Y. Miyake, MD, MSa,b, Kimberlee Gauvreau, ScDa,b, Lloyd Y. Tani, MDc,d, Robert P. Sundel, MDb,e and Jane W. Newburger, MD, MPHa,b

a Departments of Cardiology
e Pediatrics, Children's Hospital, Boston, Massachusetts
b Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
c Department of Pediatrics, Primary Children's Medical Center, Salt Lake City, Utah
d Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah

OBJECTIVE. The goal was to describe characteristics of children discharged from hospitals in the United States in 2000 with the diagnosis of acute rheumatic fever.

METHODS. We explored characteristics of children <21 years of age who were hospitalized with a diagnosis of acute rheumatic fever by using the 2000 Kids' Inpatient Database, weighted to estimate the number and rate of acute rheumatic fever–associated hospitalizations in the United States.

RESULTS. In 2000, an estimated 503 acute rheumatic fever hospitalizations occurred among children <21 years of age, at a rate of 14.8 cases per 100000 hospitalized children, with a mean age of 10 years. In comparison with all Kids' Inpatient Database admissions, acute rheumatic fever hospitalizations were more common in the age group of 6 to 11 years and among male patients. Chorea was more common in female patients (61.7%). White patients were significantly underrepresented, whereas Asian/Pacific Islander patients and patients of other races were overrepresented. Hospitalizations of patients with acute rheumatic fever were significantly more common in the Northeast and less common in the South. The highest rates of acute rheumatic fever hospitalizations occurred in Utah, Hawaii, Pennsylvania, and New York. Significantly more acute rheumatic fever admissions occurred in March. The expected payor was more likely to be private insurance and less likely to be Medicaid. Acute rheumatic fever hospitalizations were more likely to occur in teaching hospitals, freestanding children's hospitals, and children's units in general hospitals and in urban locations. The median length of stay for acute rheumatic fever hospitalizations was 3 days, and the median total charges were $6349. The in-hospital mortality rate was 0.6%.

CONCLUSIONS. In 2000, we found that hospitalizations for acute rheumatic fever were infrequent and varied according to race, season, location, and type of hospital.

Key Words: acute rheumatic fever • hospitalizations • epidemiology • children • United States

Abbreviations: ARF—acute rheumatic fever • KID—Kids' Inpatient Database • HCUP—Healthcare Cost and Utilization Project

Accepted Apr 17, 2007.


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