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American Academy of Pediatrics
Article

Hospitalizations for Severe Lower Respiratory Tract Infections

Adena H. Greenbaum, Jufu Chen, Carrie Reed, Suzanne Beavers, David Callahan, Deborah Christensen, Lyn Finelli and Alicia M. Fry
Pediatrics September 2014, 134 (3) 546-554; DOI: https://doi.org/10.1542/peds.2014-0244
Adena H. Greenbaum
aInfluenza Division, National Center for Immunizations and Respiratory Diseases,
bEpidemic Intelligence Service assigned to the Influenza Division,
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Jufu Chen
aInfluenza Division, National Center for Immunizations and Respiratory Diseases,
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Carrie Reed
aInfluenza Division, National Center for Immunizations and Respiratory Diseases,
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Suzanne Beavers
cDivision of Environmental Hazards and Health Effects, National Center for Environmental Health,
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David Callahan
dDivision for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, and
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Deborah Christensen
eDivision of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Lyn Finelli
aInfluenza Division, National Center for Immunizations and Respiratory Diseases,
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Alicia M. Fry
aInfluenza Division, National Center for Immunizations and Respiratory Diseases,
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Abstract

BACKGROUND: Hospitalization for lower respiratory tract infections (LRTIs) among children have been well characterized. We characterized hospitalizations for severe LRTI among children.

METHODS: We analyzed claims data from commercial and Medicaid insurance enrollees (MarketScan) ages 0 to 18 years from 2007 to 2011. LRTI hospitalizations were identified by the first 2 listed International Classification of Diseases, Ninth Revision discharge codes; those with ICU admission and/or receiving mechanical ventilation were defined as severe LRTI. Underlying conditions were determined from out- and inpatient discharge codes in the preceding year. We report insurance specific and combined rates that used both commercial and Medicaid rates and adjusted for age and insurance status.

RESULTS: During 2007–2011, we identified 16 797 and 12 053 severe LRTI hospitalizations among commercial and Medicaid enrollees, respectively. The rates of severe LRTI hospitalizations per 100 000 person-years were highest in children aged <1 year (commercial: 244; Medicaid: 372, respectively), and decreased with age. Among commercial enrollees, ≥1 condition increased the risk for severe LRTI (1 condition: adjusted relative risk, 2.68; 95% confidence interval, 2.58–2.78; 3 conditions: adjusted relative risk, 4.85; 95% confidence interval, 4.65–5.07) compared with children with no medical conditions. Using commercial/Medicaid combined rates, an estimated 31 289 hospitalizations for severe LRTI occurred each year in children in the United States.

CONCLUSIONS: Among children, the burden of hospitalization for severe LRTI is greatest among children aged <1 year. Children with underlying medical conditions are at greatest risk for severe LRTI hospitalization.

  • severe respiratory tract infection
  • hospitalizations
  • children
  • Accepted June 16, 2014.
  • Copyright © 2014 by the American Academy of Pediatrics

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Pediatrics
Vol. 134, Issue 3
1 Sep 2014
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Hospitalizations for Severe Lower Respiratory Tract Infections
Adena H. Greenbaum, Jufu Chen, Carrie Reed, Suzanne Beavers, David Callahan, Deborah Christensen, Lyn Finelli, Alicia M. Fry
Pediatrics Sep 2014, 134 (3) 546-554; DOI: 10.1542/peds.2014-0244

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Hospitalizations for Severe Lower Respiratory Tract Infections
Adena H. Greenbaum, Jufu Chen, Carrie Reed, Suzanne Beavers, David Callahan, Deborah Christensen, Lyn Finelli, Alicia M. Fry
Pediatrics Sep 2014, 134 (3) 546-554; DOI: 10.1542/peds.2014-0244
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