title: Predictors of long length of stay in infants hospitalized with urinary tract infection.
abstract: OBJECTIVE
  Urinary tract infection (UTI) is the most common serious bacterial infection in infants. To use resources optimally, factors contributing to costs through length of stay (LOS) must be identified. This study sought to identify clinical and health system factors associated with long LOS in infants with UTI.
  
  
  METHODS
  Using a case-control design, we included infants <6 months old hospitalized with UTI. Cases had LOS ≥96 hours; controls had LOS <96 hours. Clinical and health system variables were extracted from medical records. Cases and controls were compared by using comparative statistics and multiple logistic regression analysis.
  
  
  RESULTS
  Cases (n = 71) and controls (n = 71) did not differ by gender; cases were more likely to be younger (4.2 vs 7.1 weeks, P = .04), born preterm (13% vs 3%, P = .03), have known genitourinary disease (17% vs 4%, P = .01), an ultrasound (85% vs 68%, P = .02) or voiding cystourethrogram (VCUG) (61% vs 34%, P = .001) ordered, longer wait for VCUG (53 vs 27 hours, P = .002), consult requested (54% vs 10%, P < .001), and longer duration of intravenous (IV) antibiotics (125 vs 62 hours, P < .001). Multiple logistic regression demonstrated that cases were more likely to be premature (odds ratio [OR] 7.6), have known genitourinary disease (OR 7.3), and have VCUG ordered in the hospital (OR 4.5).
  
  
  CONCLUSIONS
  Infants who are older, are born full term, have no genitourinary disease, receive shorter courses of IV antibiotics, and do not have a VCUG ordered have shorter stays and may be eligible for a short-stay unit. Earlier transition to oral antibiotics and delayed ordering of a VCUG may decrease LOS.
authors.affiliation: Undergraduate Medical Education Doctor of Medicine Program.
authors.forename: Janet A
authors.initials: JA
authors.lastname: McMullen
authors.affiliation: Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada, and Child Health Evaluative Sciences, and Department of Paediatrics, Faculty of Medicine Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Mahant
authors.affiliation: Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada, and.
authors.forename: Julie M
authors.initials: JM
authors.lastname: DeGroot
authors.affiliation: Clinical Research Sciences, SickKids Research Institute, Toronto, Ontario, Canada Dalla Lana School of Public Health, and.
authors.forename: Derek
authors.initials: D
authors.lastname: Stephens
authors.affiliation: Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada, and Child Health Evaluative Sciences, and Department of Paediatrics, Faculty of Medicine Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada patricia.parkin@sickkids.ca.
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Parkin
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D014552:Urinary Tract Infections / Q000628:therapy*
keywords: diagnostic imaging; length of stay; pediatrics; urinary tract infections