Variables Explaining the Duration of Hospitalization in Children under Two Years of Age Admitted with Acute Airway Infections: Does Respiratory Syncytial Virus Have a Direct Impact?
| Autor: | W. Puppe, Heinz-Josef Schmitt, J. A. I. Weigl |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Quality Assurance Health Care Pneumonia Viral Respiratory Syncytial Virus Infections Disease Risk Factors Germany Lower respiratory tract infection medicine Humans Respiratory system Bronchitis Respiratory Tract Infections Reverse Transcriptase Polymerase Chain Reaction business.industry Infant Length of Stay medicine.disease Respiratory Syncytial Viruses Pneumonia Bronchiolitis Case-Control Studies Acute Disease Multivariate Analysis Pediatrics Perinatology and Child Health Etiology Population study Female business Airway |
| Zdroj: | Klinische Pädiatrie. 216:7-15 |
| ISSN: | 1439-3824 0300-8630 |
| Popis: | BACKGROUND Duration of hospitalization is influenced by many factors. It is an important parameter for quality of care. So far it is unknown, whether respiratory syncytial virus (RSV) etiology itself contributes to the time in hospital. METHOD Children under 2 years of age admitted with a lower respiratory tract infection in 3 hospitals (1 tertiary and 2 secondary centers) in northern Germany were included in an unmatched, hospital-based case-control study. Cases were children tested positive for RSV by multiplex RT-PCR. One control group consisted of children tested negative for RSV in the multiplex-RT-PCR and a second control group consisted of patients in whom no PCR was done. Since only 4 to 5% in the latter group and thus 2% of the study population were misclassified, this group could be involved in the analysis. RESULTS The median days of hospitalization was 7 days; 9 days in the RSV-positive group, 8 and 6 days in the RSV-negative and non-PCR group, respectively. The time in hospital was diminishing over the 4 year observation period. Duration of hospitalization was best predicted by--young age, presence of an underlying condition, disease entity--being pneumonia or bronchiolitis, prematurity, earlier epidemiologic year and intercostal retractions. Not predictive were: RSV-etiology, center, duration of illness, wheezing, C-reactive protein level and consolidation on the chest x-ray (all on admission). CONCLUSIONS RSV-etiology is influencing the duration of hospitalization only indirectly via its predilection for the very young age and certain underlying conditions--not by RSV itself. In spite of considerable variation of patient populations between secondary and tertiary care facilities and locally different care practices, the treatment center pre se did not influence the duration of hospitalization significantly. Further rationalization of treatment is, however, possible. |
| Databáze: | OpenAIRE |
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