Abstract
Introduction: A history of pre-maturity may be a risk factor for complications in patients under 24 months of age hospitalized for viral respiratory infections (VRIs).Objective: To identify the impact of a history of pre-maturity on in-hospital complications and mortality in patients under 24 months of age who were hospitalized for VRIs over a period of 5 years.Material and Methods: This was a propensity score-matched study. The database was compiled by physicians, electronically validated by engineers, and analyzed by statisticians. Patients diagnosed with VRIs (based on International Classification of Diseases [ICD-10]) codes B974, J12, J120–J129X, J168, J17, J171, J178, J20, J203–J209, J21, J210, J211, J218, J219, J22X, and J189) from 2013 to 2017 were enrolled in the study. The subjects were classified into two groups according to the absence or presence of a history of pre-maturity (P070, P072, P073). Patients with congenital heart disease (CHD) (Q20–Q26) were excluded. Length of hospital stay, in-hospital complications, surgical procedures, and mortality were analyzed.Statistical Analysis: Patients were matched according to age. For comparisons between groups, Student's t-tests and chi2 tests were applied. A logistic regression model was constructed to identify factors related to in-hospital complications and mortality.Results: In total, 5,880 patients were eligible for inclusion in the analysis. The average patient age was 14.25 weeks. The presence of pre-maturity (coefficient = 1.16), male sex, bronchopulmonary dysplasia (BPD), in-hospital infectious complications (coefficient = 11.31), and invasive medical procedures (coefficient = 18.4) increased the number of days of hospitalization. Invasive medical procedures (OR = 6.13), a history of pre-maturity (OR = 2.54), and male sex (OR = 1.78) increased the risk for in-hospital complications. In-hospital infectious complications (OR = 84.2) and invasive medical procedures (OR = 58.4) were risk factors for mortality.Conclusions: A history of pre-maturity increased the length of hospital stay and the rate of in-hospital complications but did not increase mortality in patients under 24 months of age hospitalized for VRIs.
Highlights
A history of pre-maturity may be a risk factor for complications in patients under 24 months of age hospitalized for viral respiratory infections (VRIs)
The respiratory infections requiring hospitalization in children under 4 years of age are predominantly of a viral etiology; only 10% are due to rhinoviruses, and the remaining 90% are due to respiratory syncytial virus (RSV) or a combination of RSV and rhinoviruses or bocaviruses [9,10,11]
The results suggested that patients with a history of pre-maturity had longer hospital stays during a VRI than those without a history of pre-maturity, the difference in the length of hospital stay between the groups increased when patients were matched
Summary
A history of pre-maturity may be a risk factor for complications in patients under 24 months of age hospitalized for viral respiratory infections (VRIs). Viral infections are common causes of respiratory tract disease in the outpatient settings of hospitals without isolation units. It is estimated that for some viruses, such as respiratory syncytial virus (RSV), 95% of children experience at least one infection before 2 years of age [1, 2]. The respiratory infections requiring hospitalization in children under 4 years of age are predominantly of a viral etiology; only 10% are due to rhinoviruses, and the remaining 90% are due to RSV or a combination of RSV and rhinoviruses or bocaviruses [9,10,11]. Specific therapies for these viruses are not yet available, viral identification can help reduce antibiotic use [12]
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