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Takotsubo cardiomyopathy in children

Published online by Cambridge University Press:  26 August 2020

Prithvi Sendi Open the ORCID record for Prithvi Sendi [Opens in a new window] ,
Paul Martinez ,
Madhuradhar Chegondi  and
Balagangadhar R. Totapally
Prithvi Sendi*
Affiliation:
Division of Critical Care Medicine, Nicklaus Children’s Hospital & Department of Pediatrics, Miami, FL, USA Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
Paul Martinez
Affiliation:
Division of Critical Care Medicine, Nicklaus Children’s Hospital & Department of Pediatrics, Miami, FL, USA Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
Madhuradhar Chegondi
Affiliation:
Division of Critical Care Medicine, Stead Family Children’s Hospital & Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Balagangadhar R. Totapally
Affiliation:
Division of Critical Care Medicine, Nicklaus Children’s Hospital & Department of Pediatrics, Miami, FL, USA Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
*
Author for correspondence: Prithvi Sendi, MD, Division of Critical Care Medicine, Nicklaus Children’s Hospital, 3100 SW 62nd Avenue, Miami, FL33155, USA. Tel: +1 305 662 2639; Fax: +1 305 663 0530. E-mail: Prithviraj.sendikeshavamurthy@nicklaushealth.org
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Abstract

Objective:

To explore the epidemiology and outcomes of takotsubo cardiomyopathy in children.

Methods:

A retrospective analysis of the Healthcare Cost and Utilization 2012 and 2016 Kids’ Inpatient Database was performed. Patients admitted with the diagnosis of takotsubo cardiomyopathy in the age group of 1 month–20 years were identified using International Classification of Diseases (ICD)-9 code 429.83 and ICD-10 code I51.81.

Results:

Among a total of 4,860,859 discharges, there were 153 with the diagnosis of takotsubo cardiomyopathy (3.1 per 100,000 discharges). Among patients with takotsubo cardiomyopathy, 55.0% were male, 62.4% were white, and 16.7% were black. Eighty-nine percent of patients were between 12 and 20 years. Psychiatric diagnosis was documented in 46% and substance use disorder in 36.2%. Sepsis was documented in 22.8% of patients. The median length of stay was 5 days (interquartile range: 2.7–15), and median total charges were $75,080 (interquartile range: 32,176–198,336). The overall mortality for takotsubo cardiomyopathy was 7%. On multivariable regression analysis, mortality was higher in the presence of anoxic injury (odds ratio = 34.42, 95% confidence interval: 4.85–320.11, p = 0.00).

Conclusions:

Takotsubo cardiomyopathy is uncommon in children and carries a mortality rate of 7%. Most children with takotsubo cardiomyopathy are adolescent males, many of whom have psychiatric disorder or substance use disorder or both. Takotsubo cardiomyopathy should be considered in the differential diagnosis for patients who present with cardiac dysfunction and have underlying psychiatric disorders or drug abuse.

Keywords

Takotsubo cardiomyopathycardiomyopathychildheart failureKids’ Inpatient Databasemortality
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 11 , November 2020 , pp. 1711 - 1715
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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