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.