Impact of AHA's 2007 guideline change on incidence of Infective Endocarditis in Infants and Children

Objectives Use a nationally-representative sample to assess impacts of new clinical guidelines issued by the American Heart Association (AHA) in 2007 for many types of invasive procedures, with recommendations for significant decreases in antimicrobial prophylaxis use. Study Design Interrupted time...

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Bibliographic Details
Published in:The American heart journal 2017-07, Vol.189, p.110-119
Main Authors: Bizmark, Rie Sakai, Chang, Ruey-Kang R, Tsugawa, Yusuke, Zangwill, Kenneth M, Kawachi, Ichiro
Format: Article
Language:English
Subjects:
Adolescent
Age
American Heart Association
Antibiotics
Cardiovascular
Child
Child, Preschool
Children
Disease
Endocarditis
Endocarditis, Bacterial - epidemiology
Endocarditis, Bacterial - prevention & control
Female
Guidelines
Heart
Hospital Mortality - trends
Hospitalization - trends
Hospitals
Humans
Incidence
Infant
Infant, Newborn
Infants
Inpatients - statistics & numerical data
Male
Mortality
Pathogens
Patient Protection & Affordable Care Act 2010-US
Patients
Pediatrics
Pneumonia
Population
Practice Guidelines as Topic - standards
Prophylaxis
Risk Assessment - methods
Risk Factors
Studies
United States - epidemiology
Variables
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Summary:Objectives Use a nationally-representative sample to assess impacts of new clinical guidelines issued by the American Heart Association (AHA) in 2007 for many types of invasive procedures, with recommendations for significant decreases in antimicrobial prophylaxis use. Study Design Interrupted time series analyses of pediatric hospitalizations for Infective Endocarditis (IE), using the Nationwide Inpatient Sample (NIS) ICD-9-CM diagnostic codes, identified IE hospitalizations for patients 10 y/o, comparing pre-guideline to post-guideline periods, but not in children 0–9 years of age. Neither in-hospital mortality nor length of stay changed significantly during study. Conclusions The data did not demonstrate an impact of the 2007 guideline changes on overall incidence of pediatric IE. However, a significant increase in disease incidence trend due to VGS was observed for the 10–17 y/o group, compared pre- and post-guideline.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2017.04.006