663: ADENOVIRUS PNEUMONIA AND ACUTE RESPIRATORY FAILURE IN U.S. CHILDREN A DESCRIPTIVE STUDY

Abstract

1JMI Laboratories, North Liberty, IA Learning Objectives: Objective: To describe the demographic characteristics and outcomes of children in the United States with adenovirus pneumonia who required mechanical ventilation. Methods: Methods: Demographic and outcome data were obtained for children less than 21 years of age who were found to have both adenovirus pneumonia and the need for mechanical ventilation from the 2012 Kids Inpatient Database (KID). We made two comparisons. First, we compared ventilated with non-ventilated children with adenovirus pneumonia. Second, we compared ventilated children with adenovirus pneumonia with ventilated children with non-adenovirus pneumonia. Statistical methods included chi-square analysis, student T-test and propensity score matching. Sample weighing was used to calculate national estimates. Results: Results: A total of 100 discharges with mechanically ventilated children and adenovirus pneumonia were identified. The majority of cases occurred in infants (27%) and pre-school age (46.6%) children. Sixty-six percent had Medicaid and 31% had commercial insurance. Thirty-seven percent of the cases were from zip codes in lowest quartile for medium household income. Chronic pulmonary disease and neurologic conditions were present as comorbidities in 22% and 26%, respectively. Eighty-three percent had one or more comorbidities. Males were less likely to be mechanically ventilated than females (OR 0.661; 95% CI: 0.445 – 0.982). Infants, preschool children and children from the southern U.S. were more likely to be mechanically ventilated (2 < 0.05). The mortality rate for mechanically ventilated children with adenovirus pneumonia was 12%. Comparison by univariate analysis between mechanically ventilated children with adenovirus infection and mechanically ventilated children with non-adenovirus pneumonia suggested a higher mortality rate in the former group (OR 1.862; 05% CI: 1.016 – 3.412). However, propensity matching (1:2) failed to find any difference in mortality between the groups. Furthermore, there was no difference in the need for ECMO, CPR, vasoactive medications or arterial pressure monitoring between these groups. Conclusions: Conclusion: The mortality rate in mechanically ventilated children with adenovirus pneumonia in the U.S. was 12% in 2012. Most children with adenovirus pneumonia had one or more comorbidity. Adenovirus pneumonia that required mechanical ventilation was most prevalent in infants, pre-school children and children from southern regions of the U.S.