title: Factors associated with disease severity in children with bronchiolitis.
abstract: OBJECTIVE
  Bronchiolitis is one of the top causes of hospitalization of infants in the United States. Several clinical factors have been associated with hospitalization; however, few studies have examined factors related to severe disease. Our goal was to describe the clinical characteristics and hospital course of children admitted with bronchiolitis and to identify factors related to intensive care unit (ICU) admission in this population.
  
  
  METHODS
  We conducted a retrospective review of all children less than 2 years of age admitted to a children's hospital with bronchiolitis between July 2008 and July 2011. Demographic and clinical data were collected including information regarding hospital course, treatments received and respiratory pathogens.
  
  
  RESULTS
  During the study period, 734 children were admitted to the hospital with bronchiolitis, 22% of whom were admitted to the ICU and 10% of whom were intubated and mechanically ventilated. Admission to the ICU was associated with younger age [110 (45-210) days versus 69 (35-149) days, p < 0.001] and history of premature birth (OR 1.7, 95% CI 1.1-2.4, p = 0.01), but not with race or ethnicity. The use of respiratory treatments was common in the children admitted to the ICU but was not associated with shortened durations of hospitalization. In addition, neither prematurity nor young age were associated with either increased duration of hospitalization or with increased likelihood of mechanical ventilation.
  
  
  CONCLUSIONS
  During acute bronchiolitis infections, younger children and those with a history of prematurity were more likely to be admitted to the ICU with severe disease.
authors.affiliation: Department of Pediatric Critical Care, Connecticut Children's Medical Center , Hartford, CT , USA.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sala
authors.forename: Ava
authors.initials: A
authors.lastname: Moore
authors.forename: Shreena
authors.initials: S
authors.lastname: Desai
authors.forename: Katelyn
authors.initials: K
authors.lastname: Welch
authors.forename: Shreya
authors.initials: S
authors.lastname: Bhandari
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Carroll
mesh_terms: D000367:Age Factors; D001424:Bacterial Infections / Q000453:epidemiology; D001988:Bronchiolitis / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006760:Hospitalization; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D047928:Premature Birth; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014481:United States; D014777:Virus Diseases / Q000453:epidemiology
keywords: Critical care; RSV; intubation; mechanical ventilation; pediatrics