title: Factors predicting prolonged hospital stay for infants with bronchiolitis.
abstract: BACKGROUND
  Prior prediction models for length of stay (LOS) in bronchiolitis have focused more on birth- and disease-related risk factors than on early hospital course factors, particularly common clinical markers including respiratory status and caloric intake.
  
  
  OBJECTIVE
  1) Study the associations of various clinical markers and LOS; and 2) develop a LOS prediction model.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Children's Hospital of Wisconsin.
  
  
  METHODS
  Inclusion criteria were: age < 365 days old; admission between November 1, 2004 and April 15, 2005; final diagnosis of bronchiolitis; placement on the bronchiolitis treatment protocol; and lack of concurrent condition impacting LOS.
  
  
  RESULTS
  During the study period, 272/347 infants admitted with bronchiolitis met inclusion criteria. On hospital day 2, infants in the prolonged LOS group (≥ 108 hours) had a significantly greater number of hours on supplemental oxygen, maximum supplemental oxygen use, minimum supplemental oxygen use, maximum respiratory rate, mean respiratory score, and number of times suctioned. They had significantly lower minimum oxygen saturation and caloric intake. Recursive partitioning demonstrated five variables (hours of supplemental oxygen, maximum respiratory rate, minimum supplemental oxygen use, gestation, and caloric intake) to predict short or prolonged LOS with an area under the receiver-operator characteristic curve of 0.89/0.72 in the learning/test trees; sensitivity, 0.85; and specificity, 0.82.
  
  
  CONCLUSIONS
  There are important differences between infants with bronchiolitis having short and prolonged hospital stays, including several clinical markers identifiable on hospital day 2. This model may be a useful prediction tool for targeting early interventions for high-risk infants.
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. mweisger@mcw.edu
authors.forename: Michael C
authors.initials: MC
authors.lastname: Weisgerber
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Lye
authors.forename: Shun-Hwa
authors.initials: SH
authors.lastname: Li
authors.forename: Deborah
authors.initials: D
authors.lastname: Bakalarski
authors.forename: Rainer
authors.initials: R
authors.lastname: Gedeit
authors.forename: Pippa
authors.initials: P
authors.lastname: Simpson
authors.forename: Marc H
authors.initials: MH
authors.lastname: Gorelick
mesh_terms: D001988:Bronchiolitis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005544:Forecasting; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000639:trends*; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods / Q000639:trends; D012189:Retrospective Studies