Cardiac Manifestation Among Children with Hemolytic Uremic Syndrome.

OBJECTIVE: The primary objectives of the study were to describe the association between cardiac manifestations and in-hospital mortality among children with Hemolytic Uremic Syndrome (HUS).

STUDY DESIGN: Using the Pediatric Health Information System database, this retrospective, multi-center, cohort study identified the first HUS-related inpatient visit among children <=18 years (years 2004 to 2018). Frequency of selected cardiac manifestations and mortality rates were calculated. Multivariate analysis identified the association of specific cardiac manifestations and the risk of in-hospital mortality.

RESULTS: Among 3,915 patients in the analysis, 238 (6.1%) had cardiac manifestations. A majority of patients (82.8%; n=197) had 1 cardiac condition, 17.2% (n=41) had 2, or or more cardiac conditions. The most common cardiac conditions was pericardial disease (n=102), followed by congestive heart failure (n=46), and cardiomyopathy/ myocarditis (n=34). The percent mortality for patients with 0, 1, 2 or more cardiac conditions was 2.1%, 17.3%, and 19.5%, respectively. Patients with any cardiac condition had an increased odds of mortality (OR 9.74; P = .0001). In additional models, the presence of 2 or more cardiac conditions (OR-9.90; p<0.001), cardiac arrest (OR- 38.25; p<0.001), or ECMO deployment (OR- 11.61; p<0.001) were associated with increased risk of in-hospital mortality.

CONCLUSION(S): This study identified differences in in-hospital mortality based on the type of cardiac manifestations, with increased risk observed for patients with multiple cardiac involvement, cardiac arrest, and ECMO deployment.