Morbidity and mortality after RSV-associated hospitalizations among premature Canadian infants

Abstract

Objective: To evaluate the impact of respiratory syncytial virus (RSV) infections on subsequent health care resource utilization in preterm infants.

Study design: Analysis of data from 2415 preterm infants (32 to 35 weeks gestational age [GA]) hospitalized for proven or probable RSV and matched to 20,254 control infants.

Results: Mean (SD) age at the index admission was 7.7 (5.5) months; 46% of the infants were male. Mean (SD) subsequent health services, excluding the index event, for the RSV cohort and control infants, respectively, were hospitalization, 2.96 (2.81) versus 1.28 (1.42); special care unit visits, 0.67 (1.70) versus 0.40 (0.33); respiratory therapy visits, 0:31 (0.70) versus 0.13 (0.37); physician consults, 3.61 (4.54) versus 0.89 (1.12); in-hospital procedures, 1.05 (4.02) versus 0.81 (1.51); outpatient visits, 18.4 (10.58) versus 7.54 (4.31); and mean (SD) inpatient days, 14.71 (18.69) versus 5.04 (7.09). All differences were statistically significant (P<.001). Diagnoses for the RSV and control cohorts were respiratory conditions (64% versus 13%), fever (2.7% versus 0.7%), anorexia (2.2% versus 0.6%), lack of normal physiological development (2.8% versus 1.1%; P<.05), overall deaths (8.1% versus 1.6%; P<.001), and sudden death (6.1% versus 0.3%; P<.001).

Conclusions: RSV hospitalization in healthy premature infants is associated with a significant increase in subsequent health care resource utilization and mortality. Results support prophylaxis of premature infants against RSV hospitalization.