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Erschienen in: Pediatric Cardiology 5/2020

11.03.2020 | Original Article

Congenital Heart Disease and Risk of Central Nervous System Infections: A Nationwide Cohort Study

verfasst von: Carina N. Bagge, Jesper Smit, Nicolas L. Madsen, Morten Olsen

Erschienen in: Pediatric Cardiology | Ausgabe 5/2020

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Abstract

Congenital heart disease (CHD) is associated with risk factors of central nervous system (CNS) infections including infective endocarditis, cardiac shunt physiology, and immune deficiencies. We aimed to investigate the risk of CNS infections in the CHD population compared to the general population. In this cohort study, we used Danish nationwide medical registries to identify individuals diagnosed with CHD at any age, born between 1977 and 2012. For each CHD individual, we matched 10 individuals on sex and birth year from the general population. Subjects were followed until first-time hospital diagnosis of CNS infection, death, emigration, or end of study. We computed cumulative incidences of CNS infections with death as a competing risk, as well as hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) adjusted for birth year and sex. We identified 17,550 individuals with CHD (50% male). Among subjects with CHD, the cumulative incidence of CNS infection at age 30 years was 1.0% compared to 0.6% in the general population. The overall HR of CNS infections in CHD subjects relative to the general population was 2.1 (95% CI 1.6–2.7). The HR was 1.9 (95% CI 1.4–2.7) for mild to moderate CHD, 2.1 (95% CI 1.3–3.3) for severe CHD and 3.0 (95% CI 1.1–8.2) for univentricular physiology. The HR for CHD subjects without record of infective endocarditis was 2.0 (95% CI 1.5–2.5). The risk of CNS infections was increased among individuals with CHD compared to the general population, and the risk was not limited to individuals with infective endocarditis.
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Literatur
1.
Zurück zum Zitat Sun R et al (2015) Congenital heart disease: causes, diagnosis, symptoms, and treatments. Cell Biochem Biophys 72(3):857–860PubMed Sun R et al (2015) Congenital heart disease: causes, diagnosis, symptoms, and treatments. Cell Biochem Biophys 72(3):857–860PubMed
2.
Zurück zum Zitat Hoffman JI, Kaplan S, Liberthson RR (2004) Prevalence of congenital heart disease. Am Heart J 147(3):425–439PubMed Hoffman JI, Kaplan S, Liberthson RR (2004) Prevalence of congenital heart disease. Am Heart J 147(3):425–439PubMed
3.
Zurück zum Zitat Garne E (2004) Congenital heart defects—occurrence, surgery and prognosis in a Danish County. Scand Cardiovasc J 38(6):357–362PubMed Garne E (2004) Congenital heart defects—occurrence, surgery and prognosis in a Danish County. Scand Cardiovasc J 38(6):357–362PubMed
4.
Zurück zum Zitat Marelli AJ et al (2007) Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 115(2):163–172PubMed Marelli AJ et al (2007) Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 115(2):163–172PubMed
5.
Zurück zum Zitat Silvia MT, Licht DJ (2005) Pediatric central nervous system infections and inflammatory white matter disease. Pediatr Clin North Am 52(4):1107–1126PubMed Silvia MT, Licht DJ (2005) Pediatric central nervous system infections and inflammatory white matter disease. Pediatr Clin North Am 52(4):1107–1126PubMed
6.
Zurück zum Zitat Riddell J, Shuman EK (2012) Epidemiology of central nervous system infection Neuroimaging. Clin N Am 22(4):543–556 Riddell J, Shuman EK (2012) Epidemiology of central nervous system infection Neuroimaging. Clin N Am 22(4):543–556
7.
Zurück zum Zitat Baltimore RS et al (2015) Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation 132(15):1487–1515PubMed Baltimore RS et al (2015) Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation 132(15):1487–1515PubMed
8.
Zurück zum Zitat Elder RW, Baltimore RS (2015) The changing epidemiology of pediatric endocarditis. Infect Dis Clin N Am 29(3):513–524 Elder RW, Baltimore RS (2015) The changing epidemiology of pediatric endocarditis. Infect Dis Clin N Am 29(3):513–524
9.
Zurück zum Zitat Novy E et al (2013) Neurological complications of infective endocarditis: new breakthroughs in diagnosis and management. Med Mal Infect 43(11–12):443–450PubMed Novy E et al (2013) Neurological complications of infective endocarditis: new breakthroughs in diagnosis and management. Med Mal Infect 43(11–12):443–450PubMed
10.
Zurück zum Zitat Jortveit J et al (2018) Endocarditis in children and adolescents with congenital heart defects: a Norwegian nationwide register-based cohort study. Arch Dis Child 103(7):670–674PubMed Jortveit J et al (2018) Endocarditis in children and adolescents with congenital heart defects: a Norwegian nationwide register-based cohort study. Arch Dis Child 103(7):670–674PubMed
11.
Zurück zum Zitat Owayed AF, Campbell DM, Wang EE (2000) Underlying causes of recurrent pneumonia in children. Arch Pediatr Adolesc Med 154(2):190–194PubMed Owayed AF, Campbell DM, Wang EE (2000) Underlying causes of recurrent pneumonia in children. Arch Pediatr Adolesc Med 154(2):190–194PubMed
12.
Zurück zum Zitat Granbom E et al (2016) Respiratory tract infection and risk of hospitalization in children with congenital heart defects during season and off-season: a swedish national study. Pediatr Cardiol 37(6):1098–1105PubMedPubMedCentral Granbom E et al (2016) Respiratory tract infection and risk of hospitalization in children with congenital heart defects during season and off-season: a swedish national study. Pediatr Cardiol 37(6):1098–1105PubMedPubMedCentral
13.
Zurück zum Zitat Nyboe C et al (2014) Risk of pneumonia in adults with closed versus unclosed atrial septal defect (from a nationwide cohort study). Am J Cardiol 114(1):105–110PubMed Nyboe C et al (2014) Risk of pneumonia in adults with closed versus unclosed atrial septal defect (from a nationwide cohort study). Am J Cardiol 114(1):105–110PubMed
14.
Zurück zum Zitat Radford DJ, Lachman R, Thong YH (1986) The immunocompetence of children with congenital heart disease. Int Arch Allergy Appl Immunol 81(4):331–336PubMed Radford DJ, Lachman R, Thong YH (1986) The immunocompetence of children with congenital heart disease. Int Arch Allergy Appl Immunol 81(4):331–336PubMed
15.
Zurück zum Zitat Armstrong D (1984) Central nervous system infections in the immunocompromised host. Infection 12(Suppl 1):S58–64PubMed Armstrong D (1984) Central nervous system infections in the immunocompromised host. Infection 12(Suppl 1):S58–64PubMed
16.
Zurück zum Zitat Elder RW, George RP, McCabe NM, Rodriguez FH III, Book WM, Mahle WT, Kirk AD (2015) Immunologic aging in adults with congenital heart disease: does infant sternotomy matter? Pediatr Cardiol 36(7):1411–1416PubMedPubMedCentral Elder RW, George RP, McCabe NM, Rodriguez FH III, Book WM, Mahle WT, Kirk AD (2015) Immunologic aging in adults with congenital heart disease: does infant sternotomy matter? Pediatr Cardiol 36(7):1411–1416PubMedPubMedCentral
17.
Zurück zum Zitat Kagawa M et al (1983) Brain abscess in congenital cyanotic heart disease. J Neurosurg 58(6):913–917PubMed Kagawa M et al (1983) Brain abscess in congenital cyanotic heart disease. J Neurosurg 58(6):913–917PubMed
18.
19.
Zurück zum Zitat Kaur C, Ling EA (2008) Blood brain barrier in hypoxic-ischemic conditions. Curr Neurovasc Res 5(1):71–81PubMed Kaur C, Ling EA (2008) Blood brain barrier in hypoxic-ischemic conditions. Curr Neurovasc Res 5(1):71–81PubMed
20.
Zurück zum Zitat Limperopoulos C et al (2010) Brain volume and metabolism in fetuses with congenital heart disease: evaluation with quantitative magnetic resonance imaging and spectroscopy. Circulation 121(1):26–33PubMed Limperopoulos C et al (2010) Brain volume and metabolism in fetuses with congenital heart disease: evaluation with quantitative magnetic resonance imaging and spectroscopy. Circulation 121(1):26–33PubMed
21.
Zurück zum Zitat Sun L et al (2015) Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease. Circulation 131(15):1313–1323PubMedPubMedCentral Sun L et al (2015) Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease. Circulation 131(15):1313–1323PubMedPubMedCentral
22.
Zurück zum Zitat Lanz J et al (2015) Stroke in adults with congenital heart disease: incidence, cumulative risk, and predictors. Circulation 132(25):2385–2394CrossRef Lanz J et al (2015) Stroke in adults with congenital heart disease: incidence, cumulative risk, and predictors. Circulation 132(25):2385–2394CrossRef
23.
Zurück zum Zitat Bouchardy J et al (2009) Atrial arrhythmias in adults with congenital heart disease. Circulation 120(17):1679–1686PubMed Bouchardy J et al (2009) Atrial arrhythmias in adults with congenital heart disease. Circulation 120(17):1679–1686PubMed
24.
Zurück zum Zitat Marino BS et al (2012) Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 126(9):1143–1172PubMed Marino BS et al (2012) Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 126(9):1143–1172PubMed
25.
Zurück zum Zitat Barker GM et al (2010) Major infection after pediatric cardiac surgery: a risk estimation model. Ann Thorac Surg 89(3):843–850PubMedPubMedCentral Barker GM et al (2010) Major infection after pediatric cardiac surgery: a risk estimation model. Ann Thorac Surg 89(3):843–850PubMedPubMedCentral
26.
Zurück zum Zitat Schmidt M, Pedersen L, Sorensen HT (2014) The Danish civil registration system as a tool in epidemiology. Eur J Epidemiol 29(8):541–549PubMed Schmidt M, Pedersen L, Sorensen HT (2014) The Danish civil registration system as a tool in epidemiology. Eur J Epidemiol 29(8):541–549PubMed
27.
Zurück zum Zitat Olsen M et al (2017) Myocardial infarction in adults with congenital heart disease. Am J Cardiol 120(12):2272–2277PubMed Olsen M et al (2017) Myocardial infarction in adults with congenital heart disease. Am J Cardiol 120(12):2272–2277PubMed
28.
Zurück zum Zitat Madsen NL et al (2016) Congenital heart disease with and without cyanotic potential and the long-term risk of diabetes mellitus: a population-based follow-up study. J Am Heart Assoc 5(7):e003076PubMedPubMedCentral Madsen NL et al (2016) Congenital heart disease with and without cyanotic potential and the long-term risk of diabetes mellitus: a population-based follow-up study. J Am Heart Assoc 5(7):e003076PubMedPubMedCentral
29.
Zurück zum Zitat Schwartz SS et al (2018) Incidence and mortality of adults with pulmonary hypertension and congenital heart disease. Am J Cardiol 121(12):1610–1616PubMed Schwartz SS et al (2018) Incidence and mortality of adults with pulmonary hypertension and congenital heart disease. Am J Cardiol 121(12):1610–1616PubMed
31.
Zurück zum Zitat Murni IK et al (2017) Perioperative infections in congenital heart disease. Cardiol Young 27(S6):S14–s21PubMed Murni IK et al (2017) Perioperative infections in congenital heart disease. Cardiol Young 27(S6):S14–s21PubMed
32.
Zurück zum Zitat Moore B et al (2017) Incidence, predictors and outcomes of infective endocarditis in a contemporary adult congenital heart disease population. Int J Cardiol 249:161–165PubMed Moore B et al (2017) Incidence, predictors and outcomes of infective endocarditis in a contemporary adult congenital heart disease population. Int J Cardiol 249:161–165PubMed
33.
Zurück zum Zitat Knirsch W, Nadal D (2011) Infective endocarditis in congenital heart disease. Eur J Pediatr 170(9):1111–1127PubMed Knirsch W, Nadal D (2011) Infective endocarditis in congenital heart disease. Eur J Pediatr 170(9):1111–1127PubMed
34.
Zurück zum Zitat Morris NA et al (2014) Neurologic complications in infective endocarditis: identification, management, and impact on cardiac surgery. Neurohospitalist 4(4):213–222PubMedPubMedCentral Morris NA et al (2014) Neurologic complications in infective endocarditis: identification, management, and impact on cardiac surgery. Neurohospitalist 4(4):213–222PubMedPubMedCentral
35.
Zurück zum Zitat Lucas MJ et al (2013) Endocarditis in adults with bacterial meningitis. Circulation 127(20):2056–2062PubMed Lucas MJ et al (2013) Endocarditis in adults with bacterial meningitis. Circulation 127(20):2056–2062PubMed
36.
Zurück zum Zitat Agergaard P et al (2011) Children diagnosed with congenital cardiac malformations at the national university departments of pediatric cardiology: positive predictive values of data in the Danish National Patient Registry. Clin Epidemiol 3:61–66PubMedPubMedCentral Agergaard P et al (2011) Children diagnosed with congenital cardiac malformations at the national university departments of pediatric cardiology: positive predictive values of data in the Danish National Patient Registry. Clin Epidemiol 3:61–66PubMedPubMedCentral
37.
Zurück zum Zitat Jorgensen LK et al (2016) Validity of the coding for herpes simplex encephalitis in the Danish National Patient Registry. Clin Epidemiol 8:133–140PubMedPubMedCentral Jorgensen LK et al (2016) Validity of the coding for herpes simplex encephalitis in the Danish National Patient Registry. Clin Epidemiol 8:133–140PubMedPubMedCentral
38.
Zurück zum Zitat Bodilsen J et al (2018) Positive predictive value of ICD-10 diagnosis codes for brain abscess in the Danish National Patient Registry. Clin Epidemiol 10:1503–1508PubMedPubMedCentral Bodilsen J et al (2018) Positive predictive value of ICD-10 diagnosis codes for brain abscess in the Danish National Patient Registry. Clin Epidemiol 10:1503–1508PubMedPubMedCentral
39.
Zurück zum Zitat Howitz MF, Samuelsson S, Molbak K (2008) Declining incidence of meningococcal disease in Denmark, confirmed by a capture-recapture analysis for 1994 and 2002. Epidemiol Infect 136(8):1088–1095PubMed Howitz MF, Samuelsson S, Molbak K (2008) Declining incidence of meningococcal disease in Denmark, confirmed by a capture-recapture analysis for 1994 and 2002. Epidemiol Infect 136(8):1088–1095PubMed
40.
Zurück zum Zitat Sundboll J et al (2016) Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study. BMJ Open 6(11):e012832PubMedPubMedCentral Sundboll J et al (2016) Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study. BMJ Open 6(11):e012832PubMedPubMedCentral
41.
Zurück zum Zitat Ostergaard L et al (2018) Positive predictive value of infective endocarditis in the Danish National Patient Registry: a validation study. Epidemiol Infect 146(15):1965–1967PubMedPubMedCentral Ostergaard L et al (2018) Positive predictive value of infective endocarditis in the Danish National Patient Registry: a validation study. Epidemiol Infect 146(15):1965–1967PubMedPubMedCentral
42.
Zurück zum Zitat Thomsen RW et al (2006) Rising incidence and persistently high mortality of hospitalized pneumonia: a 10-year population-based study in Denmark. J Intern Med 259(4):410–417PubMed Thomsen RW et al (2006) Rising incidence and persistently high mortality of hospitalized pneumonia: a 10-year population-based study in Denmark. J Intern Med 259(4):410–417PubMed
43.
Zurück zum Zitat Rothman KJ (2012) Epidemiology: an introduction, 2nd edn. Oxford University Press, New York, p 268 Rothman KJ (2012) Epidemiology: an introduction, 2nd edn. Oxford University Press, New York, p 268
Metadaten
Titel
Congenital Heart Disease and Risk of Central Nervous System Infections: A Nationwide Cohort Study
verfasst von
Carina N. Bagge
Jesper Smit
Nicolas L. Madsen
Morten Olsen
Publikationsdatum
11.03.2020
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 5/2020
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-020-02324-z

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