Length of Stay and Complications Associated With Febrile Infants

Abstract

Zangwill et al1 present a statistically rigorous study designed to evaluate whether there was a change in length of stay (LOS) for young, febrile infants hospitalized for evaluation between 2000 and 2012. Using a national data set, in combination with state agencies’ discharge databases, the authors of this study retrospectively analyzed LOS, risk factors for prolonged LOS, complications, and results of viral testing of >40 000 infants <90 days of age. The authors conclude that LOS for febrile infants did not change significantly during this 12-year period. This was contrary to their hypothesis that changes in epidemiology of bacterial infections and increased use of viral testing should have led to a decrease in LOS for these infants. The authors conclude that “targeted effort to raise awareness and implications of these issues in the care of inpatients”1 is needed. If the authors’ hypothesis is correct (that LOS should have decreased and did not), our field has work to do. If we have failed to appropriately shorten LOS in a population deserving of it, then we are falling short of adequately using the tools and knowledge at our disposal to meaningfully adapt our practice, which would be concerning. However, we must critically assess the 2 points made by the authors with regard as to why a shorter LOS was hypothesized for well-appearing, febrile infants: …