Factors predicting length of stay in bronchiolitis. (January 2020)

• Record Type: Journal Article
• Authors: Masarweh, Kamal; Gur, Michal; Leiba, Ronit; Bar-Yoseph, Ronen; Toukan, Yazeed; Nir, Vered; Gut, Guy; Ben-David, Yael; Hakim, Fahed; Bentur, Lea
• Is Part Of: Respiratory medicine. Volume 161(2020)
• Publication Date: 2020-01
• Subjects: Bronchiolitis -- Length of stay -- MDClone; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2019.105824
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Introduction: Despite advances in medical knowledge, the treatment of viral bronchiolitis is mainly supportive. Antiviral therapies are being investigated in clinical trials. Identifying population-attributable risk factors for RSV hospitalization may help prioritizing targeted treatment. Aim: To utilize MDClone, a data acquisition tool, to examine factors associated with the risk of hospitalization and length of stay (LOS) in bronchiolitis. Methods: A single tertiary medical center retrospective study. Infants discharged with a diagnosis of bronchiolitis between January 2001 and March 2019 were included. Demographic, clinical, laboratory, microbiologic parameters and co-morbidities were collected. Correlations with the risk of hospitalization and LOS were examined. Results: A total of 4793 infants with bronchiolitis, 3851 (80.3%) previously healthy, were seen; 975 visited emergency room only; 3311 were hospitalized in pediatric wards and 507 required pediatric intensive care unit. O2 saturation, age and fever correlated with the risk of hospitalization (OR = 0.703, p < 0.0001, OR = 0.4, p = 0.024 and OR = 2.388, p < 0.0001, respectively). Saturation, fever, gestational age and birth weight correlated with LOS (r = −0.283, p = 0.000; r = 0.16, p = 0.000; r = −0.12, p = 0.00; and r = −0.117, p = 0.00, respectively). Rates of hospitalization were higher (81.1% vs. 75.6%, p = 0.0008) and LOS was longer (median 2.97 vs. 2.73 days, p < 0.001) in Arabs than in Jews. In a multivariate model, saturation, fever, gestational age and age predicted LOS. Saturation and ethnicity predicted LOS for previously healthy infants. Prematurity and cardiac anomalies increased LOS ( p = 0.016 and p < 0.0001, respectively). Conclusions: Population-based data may enable predicting disease severity and LOS in bronchiolitis. Focusing on children at greatest risk may aid targeting new therapies. Highlights: Identifying risk factors for RSV hospitalization may help targeting treatment. A large database was analyzed for factors associated with length of stay. Saturation, fever, gestational age and birth weight correlated with length of stay. Ethnic disparities contribute to length of stay.