Respiratory failure at presentation in pediatric acute flaccid myelitis was associated with higher Modified Rankin Scores (MD 1.29; 95% CI 0.34-2.23) and more respiratory-related hospital visits.
Cohort (n=37)
Does respiratory failure at presentation worsen long-term respiratory and neurologic outcomes in pediatric patients with acute flaccid myelitis?
In pediatric patients with acute flaccid myelitis, respiratory failure at presentation is associated with worse long-term neurologic outcomes and higher healthcare utilization.
Mean Difference: 1.29 (95% CI 0.34–2.23)
BACKGROUND: Acute flaccid myelitis (AFM), an infection-mediated neurologic condition, may be accompanied by respiratory failure and subsequent variable recovery. This study assessed and provided prescriptive data on long-term respiratory and neurologic outcomes according to respiratory status at the time of presentation. METHODS: This was a retrospective cohort study using a large, single-payer healthcare database to identify children 1-18 years old, diagnosed with AFM between January 1, 2011 and December 31, 2019. Descriptive statistics described the overall cohort and the cohort by respiratory failure status. Bivariate analyses evaluated incidence rate ratios of outcome data, comparing those with respiratory failure to those without. RESULTS: A total of 37 patients met the study criteria for AFM; 28 were from a previously established cohort. Median follow-up time was 4.7 years interquartile range (IQR): 2.39-6.06. Overall incidence rate of AFM over the study period was 0.6 per 100,000 person-years. Eight patients (21.6%) had respiratory failure during the index hospitalization. Among children with respiratory failure, 6 patients (75%) required follow-up respiratory support. Those with respiratory failure had higher Modified Rankin Scores mean difference 1.29, 95% confidence interval (CI): 0.34-2.23 and a higher rate of respiratory-related emergency and in-hospital visits (incidence rate ratios 1.94; 95% CI: 1.27-2.96) compared to those without respiratory failure. CONCLUSIONS: Having respiratory failure at presentation was observed to have worse outcomes, including the need for long-term respiratory support, higher healthcare utilization, and prolonged neurologic deficits. This study contributes to the scant literature on pediatric patients with AFM.
Patel et al. (Tue,) conducted a cohort in Acute flaccid myelitis (AFM) (n=37). Respiratory failure at presentation vs. No respiratory failure at presentation was evaluated on Modified Rankin Scores (MD 1.29, 95% CI 0.34-2.23). Respiratory failure at presentation in pediatric acute flaccid myelitis was associated with higher Modified Rankin Scores (MD 1.29; 95% CI 0.34-2.23) and more respiratory-related hospital visits.