Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-23T18:43:21.205Z Has data issue: false hasContentIssue false
  • English
  • Français

Trends and presentation patterns of acute rheumatic fever hospitalisations in the United States

Published online by Cambridge University Press:  01 October 2019

Tyler Bradley-Hewitt ,
Chris T. Longenecker ,
Vuyisile Nkomo ,
Whitney Osborne ,
Craig Sable ,
Amy Scheel ,
Liesl Zühlke Open the ORCID record for Liesl Zühlke [Opens in a new window] ,
David Watkins  and
Andrea Beaton Open the ORCID record for Andrea Beaton [Opens in a new window]
Tyler Bradley-Hewitt
Affiliation:
Department of Pediatric Cardiology, CS Mott Children’s Hospital, The University of Michigan, Ann Arbor, MI, USA
Chris T. Longenecker
Affiliation:
Department of Cardiology, Case Western Reserve University, Cleveland, OH, USA
Vuyisile Nkomo
Affiliation:
Department of Cardiology, Mayo Clinic, Rochester, MN, USA
Whitney Osborne
Affiliation:
Department of Pediatric Cardiology, Children’s National Health System, Washington, DC, USA
Craig Sable
Affiliation:
Department of Pediatric Cardiology, Children’s National Health System, Washington, DC, USA
Amy Scheel
Affiliation:
Department of Pediatric Cardiology, Children’s National Health System, Washington, DC, USA
Liesl Zühlke
Affiliation:
Department of Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
David Watkins
Affiliation:
Department of Internal Medicine, University of Washington, Seattle, WA, USA
Andrea Beaton*
Affiliation:
Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
*
Author for correspondence: A. Beaton, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. Tel: 513-803-7574; Fax: 513-636-0162; E-mail: andrea.beaton@cchmc.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Rheumatic fever, an immune sequela of untreated streptococcal infections, is an important contributor to global cardiovascular disease. The goal of this study was to describe trends, characteristics, and cost burden of children discharged from hospitals with a diagnosis of RF from 2000 to 2012 within the United States.

Methods:

Using the Kids’ Inpatient Database, we examined characteristics of children discharged from hospitals with the diagnosis of rheumatic fever over time including: overall hospitalisation rates, age, gender, race/ethnicity, regional differences, payer type, length of stay, and charges.

Results:

The estimated national cumulative incidence of rheumatic fever in the United States between 2000 and 2012 was 0.61 cases per 100,000 children. The median age was 10 years, with hospitalisations significantly more common among children aged 6–11 years. Rheumatic fever hospitalisations among Asian/Pacific Islanders were significantly over-represented. The proportion of rheumatic fever hospitalisations was greater in the Northeast and less in the South, although the highest number of rheumatic fever admissions occurred in the South. Expected payer type was more likely to be private insurance, and the median total hospital charges (adjusted for inflation to 2012 dollars) were $16,000 (interquartile range: $8900–31,200). Median length of stay was 3 days, and the case fatality ratio for RF in the United States was 0.4%.

Conclusions:

Rheumatic fever persists in the United States with an overall downwards trend between 2003 and 2012. Rheumatic fever admissions varied considerably based on age group, region, and origin.

Keywords

Rheumatic feverepidemiologydisparity research
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 11 , November 2019 , pp. 1387 - 1390
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Watkins, DA, Roth, GA. Global burden of rheumatic heart disease. N Engl J Med 2018; 378: e2.Google ScholarPubMed
Carapetis, JR, Steer, AC, Mulholland, EK, Weber, M. The global burden of group a streptococcal diseases. Lancet Infect Dis 2005; 5: 685–694.CrossRefGoogle Scholar
Global Burden of Cardiovascular Diseases C, Roth, GA, Johnson, CO, et al. The burden of cardiovascular diseases among US states, 1990–2016. JAMA Cardiol 2018; 3: 375–389.Google Scholar
HCUPnet. Healthcare Cost and Utilization Project. [Accessed July 13, 2014]; Agency for Healthcare Research and Quality. http://hcupnet.ahrq.gov.Google Scholar
Miyake, CY, Gauvreau, K, Tani, LY, Sundel, RP, Newburger, JW. Characteristics of children discharged from hospitals in the United States in 2000 with the diagnosis of acute rheumatic fever. Pediatrics 2007; 120: 503–508.CrossRefGoogle Scholar
Sika-Paotonu, D, Beaton, A, Raghu, A, Steer, A, Carapetis, J. Acute rheumatic fever and rheumatic heart disease. In: Ferretti, JJ, Stevens, DL and Fischetti, VA (eds.) Streptococcus Pyogenes: Basic Biology to Clinical Manifestations. Oklahoma City (OK), 2016.Google ScholarPubMed
Gordon, J, Kirlew, M, Schreiber, Y, et al. Acute rheumatic fever in first Nations communities in northwestern Ontario: social determinants of health “bite the heart”. Can Fam Physician 2015; 61: 881–886.Google Scholar
Roth, GA, Johnson, C, Abajobir, A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol 2017; 70: 1–25.CrossRefGoogle ScholarPubMed
Steer, AC, Kado, J, Jenney, AW, et al. Acute rheumatic fever and rheumatic heart disease in Fiji: prospective surveillance, 2005–2007. Med J Aust 2009; 190: 133–135.Google Scholar
Supplementary material: File

Bradley-Hewitt et al. supplementary material

Figure S1

Download Bradley-Hewitt et al. supplementary material(File)
File 13.1 KB