Demographic and Clinical Characteristics of Children with Primary Cardiac Tumors Hospitalized from 1997 to 2019 in the United States

Background: Cardiac tumors in children, although rare, can lead to obstruction valves or cardiac conduction problems. Large multi-site or national data on pediatric cardiac tumors is lacking. The objective of this study was to determine the prevalence of primary cardiac tumors in hospitalized children from 1997 to 2019 in the US and analyze the demographic and clinical characteristics of children with cardiac tumors. Methods: We conducted a cross-sectional analysis using the Healthcare Cost and Utilization Project's Kid's Inpatient Database from 1997 to 2019. Children with cardiac tumors were identified using ICD-9 and ICD-10 diagnosis codes. The prevalence is presented per 100,000 hospital discharges and 1,000,000 age-specific US population. The Chi-square test was used to compare the discharges with and without cardiac tumors for demographic and clinical variables. The Chi-square for linear trend (Extended Mantel-Haenszel) test was used for trend analyses. Results: There were 3,166 discharges with primary cardiac tumors out of a total of 55.1 million discharges with a hospitalization rate of 5.8 per 100,000 discharges and 4.82 per million US children. Out of all children with cardiac tumors, 29.9% were neonates, 20.7% were infants, and 71% were children less than 5 years of age. Males comprised 52.9% of all cases. An increase in the prevalence of cardiac tumors from 1997-2019 was observed (p<0.001). Of all admissions with cardiac tumors, 88.9% were reported benign, and 37.3% were admitted to Children's Hospitals. Cardiac arrhythmias were reported in 19.2%, seizures in 28%, and stroke in 1.4%. 51.9% of cases were associated with tuberous sclerosis. Cardiac surgical procedures were performed with 13.9% of patients. The overall hospital mortality rate was 1.6%. Conclusions: Primary cardiac tumor is a rare condition in children and is most common in neonates and young children. Most pediatric cardiac tumors are benign, and many are associated with tuberous sclerosis.