Abstract:
BACKGROUND:Pediatric myocarditis is a rare disease with substantial mortality. Little is known regarding its prognostic factors. We hypothesize that certain comorbidities and procedural needs may increase risks of poor outcomes. This study aims to identify prognostic factors for pediatric myocarditis. METHODS:The national Kids' Inpatient Database was used in the study. A random forests algorithm was implemented for mortality prediction based on comorbidities and procedures. Linear regression analysis was then performed to quantify their associations with mortality and length of stay. RESULTS:The prevalence of pediatric myocarditis among all pediatric hospitalizations doubled from 2003 to 2016. The mortality rate peaked in 2006 (6.7%) and declined steadily thereafter, with a rate of 3.2% in 2016. Brain injury (including encephalopathy, cerebral edema, and intracranial hemorrhage), acute kidney injury, dysrhythmias, coagulopathy, sepsis, and ECMO use were all independent prognostic factors associated with increased mortality and prolonged hospital stay. CONCLUSION:Prognostic factor identification may not be straightforward in rare diseases such as pediatric myocarditis due to small cohort size in each treating facility. Findings from this report provide insights into the prognostic factors for pediatric myocarditis, and may allow clinicians to be better prepared when informing patients and their families regarding disease outcomes. IMPACT:The rate of hospitalization due to pediatric myocarditis was increasing but the mortality rate was declining over the past decade. End organ damage, including the brain and the kidney, was associated with mortality and prolonged hospital stay in pediatric myocarditis. Tachyarrhythmias and cardiac function compromise requiring ECMO were also associated with mortality and prolonged hospital stay. A data science approach combining machine learning algorithms and conventional regression modeling using a large dataset may facilitate risk factor identification and outcome correlation in rare diseases, as illustrated in this study.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
Chou FS,Ghimire LVdoi
10.1038/s41390-020-01268-7subject
Has Abstractpub_date
2020-11-18 00:00:00eissn
0031-3998issn
1530-0447pii
10.1038/s41390-020-01268-7pub_type
杂志文章abstract::Newborn Sprague-Dawley rat pups were found to have reduced net tubular reclamation of the beta-amino acid taurine in vivo. The reabsorption of this compound increased between the 2nd and 4th week of life and the excreted taurine fell despite a rise in glomerular filtration rate indicative of increased transport with m...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197907000-00012
更新日期:1979-07-01 00:00:00
abstract::Ventilation of immature airways has been shown to result in pressure-induced deformation and alteration of mechanical properties. These changes in mechanical properties may alter the effect of compressive pressures on pressure-flow relationships. To test this hypothesis, unventilated (Group I, n = 8) and ventilated (g...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198805000-00017
更新日期:1988-05-01 00:00:00
abstract::An Epstein-Barr virus-transformed B-cell line derived from a patient with severe combined immunodeficiency who died of a lymphoreticular malignancy has been characterized. The line derived from bone marrow cultures and designated DV-1 shows surface and cytoplasmic IgM and staining with fluorescent monoclonal antibodie...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198704000-00003
更新日期:1987-04-01 00:00:00
abstract::Little information is available regarding the time, rhythm, number, and appropriate dosage of human chorionic gonadotropin (HCG) for adequate testing of testicular function in human. The time course of the effect of two, three, or seven HCG injections at intervals of one, five, and two days, respectively, on the plasm...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198006000-00009
更新日期:1980-06-01 00:00:00
abstract::The metabolism of proteoglycans in normal growth plate and the changes in growth plate morphology induced by diabetes and malnutrition were studied in rats. The proteoglycans had a significantly faster turnover (half-life measured with [35S]sulfate labeling: 25-30 h) than the cells in the growth plate. Morphometric st...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199001000-00014
更新日期:1990-01-01 00:00:00
abstract::The use of erythrocyte entrapment as a strategy to deliver and protect exogenously administered enzymes for replacement therapy in selected genetic diseases has been evaluated in a mammalian model system. The uptake, tissue distribution, intracellular localization, and in vivo lifetime of erythrocyte-entrapped bovine ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197512000-00011
更新日期:1975-12-01 00:00:00
abstract::Normal hemostasis depends in part on the balance achieved between proaggregatory and prothrombotic platelet thromboxane A2, measured as its stable end-product thromboxane B2 (TXB2), and vascular prostacyclin (PGI2), which inhibits platelet aggregation and is antithrombotic. Cystathionine-beta-synthase deficiency is ch...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198206000-00018
更新日期:1982-06-01 00:00:00
abstract::Gaucher disease, the most common of the sphingolipidoses, results from the inherited deficiency of the enzyme glucocerebrosidase (EC 3.2.1.45). Although type 2 (acute neuronopathic) Gaucher disease is associated with rapidly progressive and fatal neurologic deterioration, the pathophysiologic mechanisms leading to the...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200008000-00018
更新日期:2000-08-01 00:00:00
abstract::In eight newborn lambs, the adaption of blood to acidosis was studied by sequential measurements of P50 in vitro (pH 7.4; 37 degrees C) and P50 in vivo (animal's pH and temperature, 39 degrees C) during the course of HCl-induced metabolic acidosis. The benefit of the change in both P50 on tissue oxygen tension was stu...
journal_title:Pediatric research
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::Completely penetrant mutations in the surfactant protein B gene (SFTPB) and >75% reduction of SFTPB expression disrupt pulmonary surfactant function and cause neonatal respiratory distress syndrome. To inform studies of genetic regulation of SFTPB expression, we created a catalogue of SFTPB variants by comprehensive r...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3180a03232
更新日期:2007-08-01 00:00:00
abstract::Medium chain acyl-CoA dehydrogenase deficiency (MCAD) is a defect in the mitochondrial oxidation of fatty acids. The disorder typically presents with episodes of vomiting and hypoglycemia, sometimes with changes in mental status and hepatic failure. These Reye's-like features may culminate in coma and death. Stress, i...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199505000-00021
更新日期:1995-05-01 00:00:00
abstract:INTRODUCTION:The Coulter LH780 hematology analyzer can evaluate mean neutrophil volume (MNV), conductivity (MNC), scatter (MNS), and distribution width (DW). We sought to investigate the value of volume, conductivity, and scatter (VCS) parameters in diagnosis and treatment efficacy of neonatal sepsis. RESULTS:We obser...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2011.16
更新日期:2012-01-01 00:00:00
abstract::The isobutyryl-CoA dehydrogenase (IBD) enzyme is involved in the degradation of valine. IBD deficiency was first reported in 1998 and subsequent genetic investigations identified acyl-CoA dehydrogenase (ACAD) 8, now IBD, as the gene responsible for IBD deficiency. Only three individuals homozygous or compound heterozy...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000233085.72522.04
更新日期:2006-09-01 00:00:00
abstract::The purpose of the present study was to determine if autoregulation of cerebral blood flow (CBF) is present in the preterm fetal lamb and, if present, to measure the range of mean arterial blood pressure over which autoregulation exists. Thirty-seven measurements of CBF were made in seven preterm fetal lambs (118-122 ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198502000-00001
更新日期:1985-02-01 00:00:00
abstract::Several epithelial ion transporters are developmentally regulated in the preweaning period, at the time when the circulating levels of glucocorticoid and mineralocorticoid hormones increase. The specific role of glucocorticoids and mineralocorticoids in the maturation of epithelial ion transport is still disputed. In ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199508000-00005
更新日期:1995-08-01 00:00:00
abstract::An amendment to this paper has been published and can be accessed via a link at the top of the paper. ...
journal_title:Pediatric research
pub_type: 已发布勘误
doi:10.1038/s41390-019-0680-5
更新日期:2020-04-01 00:00:00
abstract::Infection with human immunodeficiency virus (HIV) causes a progressive immunodeficiency, often manifested in adults by the development of infections with relatively rare, opportunistic organisms. However, in HIV-infected children, recurrent serious infections with common encapsulated bacteria, as well as recurrent min...
journal_title:Pediatric research
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验,评审
doi:10.1203/00006450-199305001-00464
更新日期:1993-01-01 00:00:00
abstract::The ability of synthetic metalloporphyrins to suppress heme oxygenase activity and bilirubin formation has recently become of considerable clinical and experimental interest for suppression of jaundice in humans, including neonatal hyperbilirubinemia. The present investigation compares the biochemical effects of Sn- a...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199209000-00016
更新日期:1992-09-01 00:00:00
abstract::Response characteristics of a transcutaneous PO2 electrode to step changes in PaO2 were determined. In vitro lag time and 95% response time of a transcutaneous PO2 monitor were compared to in vivo response. Release of arterial occlusion was used to produce rapid local PaO2 changes in human infants and adults. In vitro...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198102000-00012
更新日期:1981-02-01 00:00:00
abstract::Sequential magnitude and the rate of change in tracheal mechanics after application of intermittent positive pressure (IPP), and the time constant, tau, of this deformation were determined in fetal (21 and 27 days gestation), neonatal (term, 31 days gestation) and adult rabbits. In vitro tracheal mechanics were determ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198210000-00006
更新日期:1982-10-01 00:00:00
abstract::The deficiency of gamma-glutamyl transpeptidase activity, which was evident in some but not all cystic fibrosis amniotic fluids, could be corrected by mixing with either normal fluids or nondeficient cystic fibrosis fluids. Incubation of any amniotic fluid for 20 min at 62 degrees C resulted in total loss of gamma-glu...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198412000-00025
更新日期:1984-12-01 00:00:00
abstract::A new model has been developed for the study of maternal phenylketonuria. Beginning on the 12th day of gestation the diet of pregnant rats was supplemented with 0.5% alpha-methylphenylalanine and 3% phenylalanine. This resulted in an 83% reduction of hepatic phenylalanine hydroxylase activity. The maternal plasma phen...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198205000-00014
更新日期:1982-05-01 00:00:00
abstract::Cerebellar injury has been increasingly recognized as a complication of preterm birth, with decreased cerebellar volumes seen on follow-up neuroimaging. A cohort of 38 preterm newborns, including 14 with two scans, was studied with MRI, including single-shot fast spin-echo diffusion tensor imaging (DTI) sequence speci...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3181a1fb3d
更新日期:2009-07-01 00:00:00
abstract::Platelet-activating factor (PAF) has been implicated in the pathogenesis of gastrointestinal diseases such as necrotizing enterocolitis, Crohn's disease, and ulcerative colitis. However, neither the physiologic role of PAF in the intestine, nor the mechanisms by which PAF participates in the pathogenesis of disease ar...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200208000-00005
更新日期:2002-08-01 00:00:00
abstract::Plasma amino acid levels in newborn babies are often measured as part of a screening for inherited metabolic disease, or less commonly as part of a nutritional assessment. We have examined certain factors which affect the levels as measured in low birth weight babies during the first 3 wk of life. As in other studies,...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198505000-00008
更新日期:1985-05-01 00:00:00
abstract::The auditory brainstem response (ABR) was monitored during infusion of bilirubin in six ventilated newborn rhesus monkeys (138-145 d gestation) while acute changes in pH were produced by varying inspired CO2. Prolonged respiratory acidosis without bilirubin infusion produced minimal changes in the ABR (one animal). CO...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199307000-00002
更新日期:1993-07-01 00:00:00
abstract::Chitosan is a natural, cationic polysaccharide derived from fully or partially deacetylated chitin. Chitosan is capable of inducing large phospholipid aggregates, closely resembling the function of nonionic polymers tested previously as additives to therapeutic lung surfactants. The effects of chitosan on improving th...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000227558.14024.57
更新日期:2006-08-01 00:00:00
abstract::We investigated, using a human placental choriocarcinoma cell line as a model, the effects of the immunosuppressive drug cyclosporin A on several placental transport systems mediating the transfer of glucose and amino acids from mother to fetus. The results of the investigation show that the transport system responsib...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199207000-00024
更新日期:1992-07-01 00:00:00
abstract::Hirschsprung's disease, affecting one in 5000 live newborns, is the most common cause of neonatal intestinal obstruction. The obstruction or, later in life, constipation arises from the lack of enteric ganglia in the hindgut, thus resulting in poor coordination of peristalsis. Mutations in Hirschsprung patients have s...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199905010-00018
更新日期:1999-05-01 00:00:00
abstract::Tracheal epithelial cells obtained from adult and infant ferrets were grown in primary culture in vitro. Cells from adult animals grew readily, and many ciliated cells were observed in the cultures. Successful cultures were derived from infant animals, but cell number in infant and adult cultures began to decrease aft...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199107000-00016
更新日期:1991-07-01 00:00:00