(281) Supraventricular Tachycardia in Pediatric Asthmatics Is Associated With Adverse Health Outcomes

Introduction: Supraventricular tachycardia (SVT) can occur during treatment of an acute asthma exacerbation. There are, however, no specific data on the long-term outcomes of children who are diagnosed with both asthma and SVT. This study aims to analyze the effect of SVT in asthmatic children on mortality and/or cardiac arrest, hypothesizing asthmatic subjects with SVT have increased mortality and/or cardiac arrest.

Methods: This was a retrospective cohort study, utilizing the TriNetX© electronic health record (EHR) database that included subjects aged 2 to 18 years of age, with an asthma diagnostic code and albuterol medication code for the first time in their database history (index date). The study population was divided into two groups (subjects with an SVT diagnosis before and after the index date and no-SVT diagnosis). Data related to demographics, International Classification of Diseases 10th edition diagnostic codes, procedural codes, and medication codes 7 days after the index date were collected. The primary outcome measure was any death and/or cardiac arrest in a patient after the index date in the subject’s database history. Using multivariate logistic regression, the association of SVT diagnosis in asthma patients and death and/or cardiac arrest was tested while controlling for age, sex, race, congenital heart disease, social determinants of health (SDOH) diagnostic codes, and non-cardiovascular pediatric comorbidities.

Results: Our study included 91,092 asthmatic subjects [245 (0.27%) with SVT and 90,847 (99.73%) with no-SVT]. Multivariable logistic regression analysis demonstrated that after controlling for age, SDOH, congenital heart diseases, and non-cardiovascular pediatric comorbidities, the overall odds of death and/or cardiac arrest is significantly higher in asthmatic children with SVT (OR = 4.29, CI = 2.49-7.39).

Conclusions: This retrospective analysis from a large nationwide EHR data suggests asthmatic patients with a concomitant SVT diagnosis may be at risk of adverse health outcomes. Further studies are needed to determine factors that may contribute to the increased risk of cardiac arrest and/or mortality in children with asthma and SVT, and whether these children should be managed differently.