Bronchiolitis Admissions in a Lebanese Tertiary Medical Center: A 10 Years' Experience.

Zeina Naja,Sarah Chamseddine,Danielle Fayad,Ghassan Dbaibo,Rima Hanna-Wakim,Sarah Khafaja

doi:10.3389/fped.2019.00189

Zeina Naja, Sarah Chamseddine + Show 4 more

Open Access

https://doi.org/10.3389/fped.2019.00189

Copy DOI

Abstract

Bronchiolitis and more specifically respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global childhood morbidity and mortality. Despite the previous identification of possible risk factors associated with the severity of bronchiolitis, the data from Lebanon remains limited. We described the burden of bronchiolitis hospitalizations in children under 5 years of age in a tertiary care center in Lebanon from October 2004 to October 2014 and identified the risk factors associated with severe bronchiolitis. This was a retrospective cohort study conducted at the American University of Beirut Medical Center. Records of children younger than 5 years of age admitted with a diagnosis of bronchiolitis were reviewed. More than half the patients were RSV positive. RSV bronchiolitis was found to be significantly associated with longer hospital stay compared to children with non-RSV bronchiolitis (P = 0.007). Children exposed to smoking had an increased risk for longer hospital stay (P = 0.002) and were more likely to require ICU admission (P < 0.001) and supplemental oxygen (P = 0.045). Congenital heart disease was found to be a significant risk factor for severe bronchiolitis (P < 0.005).Conclusion: Patients with RSV bronchiolitis had a longer hospital stay compared to patients with non-RSV bronchiolitis. Exposure to smoking was associated with a more severe and complicated RSV infection. Congenital heart disease was the only risk factor significantly associated with all markers of bronchiolitis disease severity.

Highlights

Lower respiratory tract infection (LRTI), including bronchiolitis and pneumonia, constitute the leading cause of global child morbidity and mortality [1]
The medical records of 362 patients were available for review; 43 patients were excluded from the final analysis because of unknown Respiratory Syncytial Virus (RSV) status leaving a final study cohort of 319 patients for statistical analysis
Contrariwise, cases of non-RSV bronchiolitis hospitalizations were most frequent during the month of December and displayed a dispersed distribution throughout the year with no significant peak in hospital admissions (Figure 2)

Summary

Introduction

Lower respiratory tract infection (LRTI), including bronchiolitis and pneumonia, constitute the leading cause of global child morbidity and mortality [1]. Bronchiolitis is considered the most common respiratory disease in young children and is a major cause of hospitalization [2]. From 1997 to 2006 in the United States, the average annual rate of bronchiolitis among children younger than 5 years of age was 27.9 per 1,000 with half a million annual hospitalizations [3]. Hospital costs for care related to bronchiolitis in children younger than 5 years of age have been on the rise in the United States and exceeded 1.7 billion US dollars in 2009 [2]. An estimated 33.8 million new episodes of RSV infections occur in Characteristics of Bronchiolitis Admissions children under 5 years of age worldwide accounting for 22% of LRTI episodes.

Objectives

Methods

Results

Discussion

Conclusion