Factors predicting length of stay in bronchiolitis

Kamal Masarweh, Michal Gur, Ronit Leiba, Ronen Bar-Yoseph, Yazeed Toukan, Vered Nir, Guy Gut, Yael Ben-David, Fahed Hakim, Lea Bentur

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

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.

Original languageEnglish
Article number105824
JournalRespiratory Medicine
Volume161
DOIs
StatePublished - Jan 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 Elsevier Ltd

Keywords

  • Bronchiolitis
  • Length of stay
  • MDClone

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