Abstract
Introduction: Bronchiolitis is the leading cause of hospitalization in children. Estimate potentially preventable variables that impact the length of hospital stay are a priority to reduce the costs associated with this disease. This study aims to identify clinical variables associated with length of hospital stay of bronchiolitis in children in a tropical middle-income country Methods: We conducted a retrospective cohort study in 417 infants with bronchiolitis in tertiary centers in Colombia. All medical records of all patients admitted to the emergency department were reviewed. To identify factors independently associated we use negative binomial regression model, to estimate incidence rate ratios (IRR) and adjust for potential confounding variables Results: The median of the length of hospital stay was 3.68 days, with a range of 0.74 days to 29 days, 138 (33.17%) of patients have a hospital stay of 5 or more days. After modeling and controlling for potential confounders age <6 months, comorbidities (CHD or neurological), BPD, chest indrawing, RSV isolation, and C-reactive protein were independent predictors of LOS Conclusions: Our results show that in infants with bronchiolitis, RSV isolation, age <6 months, comorbidities (CHD or neurological), BPD, chest indrawing, and C-reactive protein were independent predictors of LOS. As a potentially modifiable risk factor, efforts to reduce the probability of RSV infection can reduce the high medical cost associates with prolonged LOS in bronchiolitis.
Highlights
Bronchiolitis is the leading cause of hospitalization in children
This study aims to identify clinical variables associated with length of stay (LOS) of bronchiolitis in children in a tropical middle-income country
Our study shows that respiratory syncytial virus (RSV), age
Summary
Bronchiolitis is the leading cause of hospitalization in children. Estimate potentially preventable variables that impact the length of hospital stay are a priority to reduce the costs associated with this disease. Some models have identified predictors of LOS such as age, underlying conditions (congenital heart disease, chronic lung conditions, immunocompromised states), low weight, male gender, clinical characteristics at admission, prematurity, RSV isolation[6] Many of these models lack accuracy[7] or were made in patients without significant comorbidities[8]. In tropical areas in addition to genetic differences, the respiratory syncytial virus (RSV), generates differences in the burden of morbidity and mortality given the non-seasonality of these areas[9] In this context, there is a critical need to explore predictors of LOS, especially in tropical areas, improving their accuracy of current models .This information will allow risk management for healthcare and prioritize care strategies in groups with a high probability of prolonged hospital stay to reduce their impact on hospital costs and morbidity. This study aims to identify clinical variables associated with LOS of bronchiolitis in children in a tropical middle-income country
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