title: Risk factors associated with hospital admission among healthy children with adenovirus infection.
abstract: Adenovirus infections mimic bacterial infections on initial presentation in healthy children, leading to higher likelihood of hospital admission. The objective of this study was to identify risk factors associated with hospital admission in previously healthy children with adenovirus infection. This is a retrospective study of 125 previously healthy children, who tested positive with direct immunofluorescence assay (DFA) for adenoviral infection at our center between January 2001 and October 2007. The primary outcome of the study was the need for hospital admission. The relationship between clinical variables at initial emergency room (ER) presentation and need for hospital admission were explored using univariate and multivariate logistic regression models. The model's predictive value was investigated by calculating the area under the receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test. On stepwise multivariate logistic regression analysis, the presence of respiratory distress (odds ratio [OR]: 5.6; p = 0.014), acute gastroenteritis (OR: 3.8; p = 0.019) and wheezes at initial presentation (OR: 6.5; p = 0.003) at the time of initial presentation in the ER were associated with need for hospital admission. For this model, the area under the ROC curve was 0.79, and there was no evidence of lack of fit on Hosmer-Lemeshow goodness-of-fit test (p = 0.56). Our study identifies three risk factors, namely, respiratory distress, wheezing and acute gastroenteritis, associated with hospital admission for healthy children with adenoviral infections.
authors.affiliation: Section of Pediatric Cardiology and Critical Care, Department of Pediatrics, University of Arkansas Medical Center, Little Rock, Arkansas, USA.
authors.forename: Punkaj
authors.initials: P
authors.lastname: Gupta
authors.forename: Sunali
authors.initials: S
authors.lastname: Goyal
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
authors.forename: Parthak
authors.initials: P
authors.lastname: Prodhan
authors.forename: Prashant
authors.initials: P
authors.lastname: Purohit
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Gossett
authors.forename: Vinca
authors.initials: V
authors.lastname: Chow
authors.forename: Natan
authors.initials: N
authors.lastname: Noviski
mesh_terms: D000258:Adenovirus Infections, Human / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D012131:Respiratory Insufficiency / Q000209:etiology; D012135:Respiratory Sounds; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000628:therapy*; D012307:Risk Factors