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. 2010 Aug;126(2):204-13.
doi: 10.1542/peds.2009-3109. Epub 2010 Jul 19.

National hospitalization trends for pediatric pneumonia and associated complications

Grace E Lee  1 , Scott A Lorch, Seth Sheffler-Collins, Matthew P Kronman, Samir S Shah
Affiliations

National hospitalization trends for pediatric pneumonia and associated complications

Grace E Lee et al. Pediatrics. 2010 Aug.

Abstract

Objective: To determine current rates of and trends in hospitalizations for community-acquired pneumonia (CAP) and CAP-associated complications among children.

Methods: We performed a cross-sectional, retrospective, cohort study by using the 1997, 2000, 2003, and 2006 Kids' Inpatient Database. National estimates for CAP and CAP-associated local and systemic complication rates were calculated for children < or =18 years of age. Patients with comorbid conditions or in-hospital birth status were excluded. Percentage changes were calculated by using 1997 (before heptavalent pneumococcal conjugate vaccine [PCV7]) and 2006 (after PCV7) data.

Results: There were a total of 619,102 CAP discharges for 1997, 2000, 2003, and 2006, after application of inclusion and exclusion criteria. Overall rates of CAP discharges did not change substantially between 1997 and 2006, but stratification according to age revealed a 22% decrease for children <1 year of age, minimal change for children 1 to 5 years of age, and increases for children 6 to 12 years (22%) and > or =13 years (41%) of age. Systemic complication rates were highest among children <1 year of age but decreased by 36%. In all other age groups, systemic complication rates remained stable. Local complication rates increased 78% overall. Children 1 to 5 years of age had the highest local complication rates.

Conclusions: After the introduction of PCV7 in 2000, rates of CAP-associated systemic complications decreased only for children <1 year of age. Rates of pediatric CAP-associated local complications are increasing in all age groups.

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Figures

Figure 1
Figure 1
Figure 1a–d. Rate of Hospital Discharges for Community Acquired Complications, 1997–2006, Stratified by Age. (a). < 1year. (b). 1–5 years. (c). 6–12 years. (d).13–18 years. Open circles indicate any complication, solid squares indicate systemic complications, and solid circles indicate local complications. Bar lines indicate 95% confidence intervals. Rates are per 100,000 age-specific U.S. population.
Figure 1
Figure 1
Figure 1a–d. Rate of Hospital Discharges for Community Acquired Complications, 1997–2006, Stratified by Age. (a). < 1year. (b). 1–5 years. (c). 6–12 years. (d).13–18 years. Open circles indicate any complication, solid squares indicate systemic complications, and solid circles indicate local complications. Bar lines indicate 95% confidence intervals. Rates are per 100,000 age-specific U.S. population.
Figure 1
Figure 1
Figure 1a–d. Rate of Hospital Discharges for Community Acquired Complications, 1997–2006, Stratified by Age. (a). < 1year. (b). 1–5 years. (c). 6–12 years. (d).13–18 years. Open circles indicate any complication, solid squares indicate systemic complications, and solid circles indicate local complications. Bar lines indicate 95% confidence intervals. Rates are per 100,000 age-specific U.S. population.
Figure 1
Figure 1
Figure 1a–d. Rate of Hospital Discharges for Community Acquired Complications, 1997–2006, Stratified by Age. (a). < 1year. (b). 1–5 years. (c). 6–12 years. (d).13–18 years. Open circles indicate any complication, solid squares indicate systemic complications, and solid circles indicate local complications. Bar lines indicate 95% confidence intervals. Rates are per 100,000 age-specific U.S. population.
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