Duncan DR, et al. - This retrospective cohort study examined the relationship between hospitalization risk in pediatric patients with oropharyngeal dysphagia and treatment with proton pump inhibitors (PPI). It was noted that patients with enteral tubes who were prescribed PPIs were at the highest risk for admission. Compared with untreated patients, children with aspiration who were treated with PPI had increased risk of hospitalization, supporting growing concern about the risks of PPI use in children.

Methods

• For this investigation, researchers compared the frequency and length of hospitalizations for children who had abnormal results on videofluoroscopic swallow studies that were performed between January 1, 2015 and December 31, 2015, and who were or were not treated with PPI with follow-up through December 31, 2016.
• They reviewed records for children who presented for care at Boston Children’s Hospital, a tertiary referral center.
• Study participants were 293 children 2 years and younger with evidence of aspiration or penetration on videofluoroscopic swallow study.
• Hospital admission rate and hospital admission nights were the primary outcomes and these were measured as incident rates.
• To determine predictors of hospitalization risk after adjusting for comorbidities, multivariable analyses were performed.
• To determine the relationship of PPI prescribing with time until first hospitalization, Kaplan-Meier curves were created.

Results

• In this analysis, 293 patients with a mean (SD) age of 8.8 (0.4) months and a mean (SD) follow-up time of 18.15 (0.20) months were involved.
• Even after adjustment for comorbidities, findings revealed that patients treated with PPI had higher admission rates (incidence rate ratio [IRR], 1.77; 95% CI, 1.16-2.68) and admission nights (IRR, 2.51; 95% CI, 1.36-4.62).
• They observed that patients with enteral tubes who were prescribed PPIs were at the highest risk for admission (hazard ratio [HR], 2.31; 95% CI, 1.24-4.31).