title: Risk factors for admission in children with bronchiolitis from pediatric emergency department observation unit.
abstract: BACKGROUND
  Patients with bronchiolitis are increasingly being admitted to emergency department observation units (EDOUs) but often require subsequent hospitalization. To better identify ED patients who should be directly admitted to the hospital rather than the EDOU, the predictors of admission must be identified.
  
  
  OBJECTIVE
  The objective of this study was to determine the predictors of subsequent hospital admission from the EDOU in infants and young children with bronchiolitis.
  
  
  METHODS
  This was a retrospective cohort study of patients younger than 2 years admitted to an EDOU with bronchiolitis between April 1, 2003, and March 31, 2007. Univariate analysis was followed by logistic regression to identify the significant predictors of hospital admission from the EDOU.
  
  
  RESULTS
  There were 325 patients in the study: 67% were younger than 6 months, and 60% were male. Eighty-five (26%) were admitted to the hospital from the EDOU. Predictors for admission from the EDOU included parental report of poor feeding or increased work of breathing, oxygen saturation less than 93%, or ED treatment with racemic epinephrine (Vaponephrine) and intravenous fluids (IVFs).
  
  
  CONCLUSIONS
  Patients with a history of increased work of breathing or oxygen saturation less than 93% and ED treatment with IVFs are at high risk for admission from the EDOU to the hospital. Direct admission to the hospital from the ED should be considered for these patients, particularly patients treated with IVFs and having an oxygen saturation less than 93% in the ED.
authors.affiliation: Department of Pediatrics, Texas Children's Hospital, Houston, TX 77030, USA. syusuf@bcm.edu
authors.forename: Shabana
authors.initials: S
authors.lastname: Yusuf
authors.forename: A Chantal
authors.initials: AC
authors.lastname: Caviness
authors.forename: Aderonke O
authors.initials: AO
authors.lastname: Adekunle-Ojo
mesh_terms: D001988:Bronchiolitis / Q000628:therapy*; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors