(300) Epidemiology of Antihypertensive Medication Poisoning in Hospitalized Children in the U.S.

Introduction: Limited publications address the hospitalization of children with antihypertensive medication (AHTM) poisoning. We queried a U.S. national discharge database to evaluate the epidemiology and outcomes of hospitalization with AHTM poisoning in children.

Methods: We retrospectively analyzed the Health Care Utilization Project (HCUP) Kids’ Inpatient Database for non-elective admissions for the years 2016 and 2019. We used ICD-10 codes and CCSR codes to identify five categories of AHTM poisoning (beta-blocker (BB), calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), alpha-blocker (AB), central acting (CA)) and associated conditions and procedures. We used the chi-square test and binary logistic regression analysis for inferential statistical analyses. Continuous data are presented as medians with IQR and categorical data are presented as frequencies or odds ratios (OR) with 95% CI.

Results: AHTM poisoning accounted for 2,833 out of 3,469,344 discharges (8.16 per 10,000). Intentional self-harm accounted for 71%. The breakdown for AHTM poisoning was as follows: BB 58.7%, CCB 28.3%, ACEI 19.4%, AB 18%, CA 2.5%. Females accounted for 70% of the cases. The median age was 15 (11-18) years with a bimodal distribution with peaks in toddler/early childhood (1-5 years) and early adolescence (12-18 years). The median length of stay was 3 (2-4) days. On binary logistic regression analysis of all discharges, the risk of AHTM poisoning was increased with female gender (OR 1.89; 1.74-2.06), early adolescence (OR 1.39; 1.25-1.54), residence in the Midwest (OR 1.23; 1.09-1.39) or South (OR 1.25; 1.09-1.42), residence in non-large metropolitan regions ( < 1,000,000 residents) (OR 1.15; 1.07-1.25), and psychiatric diagnosis (OR 5.05; 4.63-5.58) and decreased with Hispanic ethnicity (OR 0.79; 0.70-0.89).

Conclusions: AHTM poisoning accounts for a small number of pediatric hospitalizations in the U.S. and has an in-hospital bimodal age distribution. Female gender, early adolescence, residence in the Midwest and South regions and non-large metropolitan regions, and psychiatric diagnosis are associated with a higher risk for AHTM poisoning while Hispanic ethnicity is associated with a lower risk. The mortality rate was low and cannot be further delineated (HCUP policy).