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Original research
Predictors of prolonged length of hospital stay for infants with bronchiolitis
  1. Carlos E Rodríguez-Martínez1,2,
  2. Monica P Sossa-Briceño3,
  3. Gustavo Nino4
  1. 1Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
  2. 2Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogotá, Colombia
  3. 3Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
  4. 4Division of Pediatric Pulmonary, Sleep Medicine and Integrative Systems Biology, Center for Genetic Research, Children’s National Medical Center, George Washington University, Washington, District of Columbia, USA
  1. Correspondence to Dr Carlos E Rodríguez-Martínez, Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogotá,11010, Colombia; carerodriguezmar{at}unal.edu.co

Abstract

Among inpatients suffering from bronchiolitis, approximately a quarter may undergo a prolonged length of stay (LOS) for the treatment of their respiratory condition. However, there have been few research studies that have evaluated variables that may be associated with a prolonged LOS in these patients, especially in low-income and middle-income countries, where the clinical and economic burden of the disease is the greatest. In an analytical single-center cross-sectional study, we included a population of patients with acute bronchiolitis hospitalized between March and June 2016. We collected demographic and clinical information and the LOS of each patient. Prolonged LOS for bronchiolitis was defined as at least one hospital stay of 5 or more days. A total of 303 patients were included, with 176 (58.1%) male and a median (IQR) age of 3.0 (1.0–7.0) months. After controlling for gender, history of bronchopulmonary dysplasia, number of days with respiratory symptoms, the presence of apnea as an initial manifestation of bronchiolitis, and other underlying disease conditions, we found that the independent predictors of prolonged LOS for bronchiolitis in our study population included age (OR 0.92; 95% CI 0.84 to 0.99; p=0.049), history of prematurity (OR 6.34; 95% CI 1.10 to 36.46; p=0.038), respiratory syncytial virus isolation (OR 1.92; 95% CI 1.02 to 3.73; p=0.048), and initial oxygen saturation (OR 0.94; 95% CI 0.88 to 0.98; p=0.048). The factors identified should be taken into account when planning policies to reduce the duration of hospital stay in infants with bronchiolitis.

  • bronchiolitis
  • clinical practice variations
  • length of stay
  • quality of care

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Footnotes

  • Contributors CER-M conceptualized and designed the study, carried out the final analyses, drafted the initial manuscript, and approved the final manuscript as submitted. MPS-B and GN designed the data collection instruments, carried out the initial analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted.

  • Funding This work is supported by grant nos NHLBI/HL090020 (K12 Genomics of Lung), NICHC/HD001399 (K12 Child Health Research Career Development Award), and UL1TR000075 KL2TR000076 Awards from the NIH National Center for Advancing Translational Sciences.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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