Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis

Carla G. García, Rafia Bhore, Alejandra Soriano-Fallas, Margaret Trost, Rebecca Chason, Octavio Ramilo, Asuncion Mejias

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

BACKGROUND: The trends in hospitalization rates and risk factors for severe bronchiolitis have not been recently described, especially after the routine implementation of prophylaxis for respiratory syncytial virus (RSV) infections. OBJECTIVES: To define the burden of hospitalizations related to RSV and non-RSV bronchiolitis in a tertiary-care children's hospital from 2002 to 2007 and to identify the risk factors associated with severe disease. METHODS: Medical records of patients hospitalized for bronchiolitis were reviewed for demographic, clinical, microbiologic, and radiologic characteristics as well as the presence of underlying medical conditions. Differences were evaluated between children with RSV and non-RSV bronchiolitis, and multivariable logistic regression analyses were performed to identify independent risk factors for severe disease. RESULTS: Bronchiolitis hospitalizations in children younger than 2 years old (n = 4800) significantly increased from 536 (3.3%) in 2002 to 1241 (5.5%) in 2007, mainly because of RSV infections. Patients with RSV bronchiolitis (n = 2840 [66%]) were younger at hospitalization and had a lower percentage of underlying medical conditions than children hospitalized with non-RSV bronchiolitis (27 vs 37.5%; P < .001). However, disease severity defined by length of hospitalization and requirement of supplemental oxygen, intensive care, and mechanical ventilation was significantly worse in children with RSV bronchiolitis. RSV infection and prematurity, regardless of the etiology, were identified as independent risk factors for severe bronchiolitis. CONCLUSIONS: There was a significant increase in hospitalizations for RSV bronchiolitis from 2002 to 2007. A majority of the children with RSV bronchiolitis were previously healthy, but their disease severity was worse compared with those hospitalized with non-RSV bronchiolitis.

Original languageEnglish (US)
JournalPediatrics
Volume126
Issue number6
DOIs
StatePublished - Dec 2010

Fingerprint

Bronchiolitis
Hospitalized Child
Respiratory Syncytial Viruses
Viruses
Hospitalization
Respiratory Syncytial Virus Infections
Tertiary Healthcare
Critical Care
Artificial Respiration
Medical Records
Logistic Models
Regression Analysis

Keywords

  • Bronchiolitis
  • Disease severity
  • ICD-9
  • RSV

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

García, C. G., Bhore, R., Soriano-Fallas, A., Trost, M., Chason, R., Ramilo, O., & Mejias, A. (2010). Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis. Pediatrics, 126(6). https://doi.org/10.1542/peds.2010-0507

Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis. / García, Carla G.; Bhore, Rafia; Soriano-Fallas, Alejandra; Trost, Margaret; Chason, Rebecca; Ramilo, Octavio; Mejias, Asuncion.

In: Pediatrics, Vol. 126, No. 6, 12.2010.

Research output: Contribution to journalArticle

García, CG, Bhore, R, Soriano-Fallas, A, Trost, M, Chason, R, Ramilo, O & Mejias, A 2010, 'Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis', Pediatrics, vol. 126, no. 6. https://doi.org/10.1542/peds.2010-0507
García CG, Bhore R, Soriano-Fallas A, Trost M, Chason R, Ramilo O et al. Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis. Pediatrics. 2010 Dec;126(6). https://doi.org/10.1542/peds.2010-0507
García, Carla G. ; Bhore, Rafia ; Soriano-Fallas, Alejandra ; Trost, Margaret ; Chason, Rebecca ; Ramilo, Octavio ; Mejias, Asuncion. / Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis. In: Pediatrics. 2010 ; Vol. 126, No. 6.
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abstract = "BACKGROUND: The trends in hospitalization rates and risk factors for severe bronchiolitis have not been recently described, especially after the routine implementation of prophylaxis for respiratory syncytial virus (RSV) infections. OBJECTIVES: To define the burden of hospitalizations related to RSV and non-RSV bronchiolitis in a tertiary-care children's hospital from 2002 to 2007 and to identify the risk factors associated with severe disease. METHODS: Medical records of patients hospitalized for bronchiolitis were reviewed for demographic, clinical, microbiologic, and radiologic characteristics as well as the presence of underlying medical conditions. Differences were evaluated between children with RSV and non-RSV bronchiolitis, and multivariable logistic regression analyses were performed to identify independent risk factors for severe disease. RESULTS: Bronchiolitis hospitalizations in children younger than 2 years old (n = 4800) significantly increased from 536 (3.3{\%}) in 2002 to 1241 (5.5{\%}) in 2007, mainly because of RSV infections. Patients with RSV bronchiolitis (n = 2840 [66{\%}]) were younger at hospitalization and had a lower percentage of underlying medical conditions than children hospitalized with non-RSV bronchiolitis (27 vs 37.5{\%}; P < .001). However, disease severity defined by length of hospitalization and requirement of supplemental oxygen, intensive care, and mechanical ventilation was significantly worse in children with RSV bronchiolitis. RSV infection and prematurity, regardless of the etiology, were identified as independent risk factors for severe bronchiolitis. CONCLUSIONS: There was a significant increase in hospitalizations for RSV bronchiolitis from 2002 to 2007. A majority of the children with RSV bronchiolitis were previously healthy, but their disease severity was worse compared with those hospitalized with non-RSV bronchiolitis.",
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