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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Frequency, duration and predictors of bronchiolitis episodes of care among infants ≥32 weeks gestation in a large integrated healthcare system: a retrospective cohort study

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Valerie J Flaherman, Arona I Ragins, Sherian Xu Li, Patricia Kipnis, Anthony Masaquel, Gabriel J Escobar
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-144) contains supplementary material, which is available to authorized users.

Competing interests

Dr. Anthony Masaquel is an employee of MedImmune, LLC, the company which funded the study reported here.

Authors’ contributions

VF participated in the conception and design of this study, participated in the analysis of the data, drafted the article, and has given final approval for the version to be published. AR participated in the conception and design of this study, participated in the analysis of the data, revised the manuscript critically for important intellectual content, and has given final approval for the version to be published. SXL participated in the conception and design of this study, analyzed the data, revised the manuscript critically for important intellectual content, and has given final approval for the version to be published. PK participated in data analysis, revised the manuscript critically for important intellectual content, and has given final approval for the version to be published. AM conceived and designed this study, revised the manuscript critically for important intellectual content, and has given final approval for the version to be published. GE conceived and designed this study, participated in the analysis of the data, revised the manuscript critically for important intellectual content, and has given final approval for the version to be published. All authors read and approved the final manuscript.

Abstract

Background

Bronchiolitis is common in the first two years of life and is the most frequent cause of hospitalization in this age group. No previous studies have used an episode-of-care analysis to describe the frequency, duration, and predictors of bronchiolitis episodes of care during the first two years.

Methods

We conducted a retrospective cohort study of 123,264 infants ≥32 weeks gestation born at 6 Northern California Kaiser Permanente hospitals between 1996 and 2002. We used electronic medical records to concatenate hospital, emergency department and outpatient health care encounters for bronchiolitis into discrete episodes of care. We used descriptive statistics to report frequency and duration of bronchiolitis episodes and used logistic regression to assess the effect of gestational age and other clinical and demographic predictors on the outcome of bronchiolitis episodes.

Results

Among all infants, the rate of bronchiolitis episodes was 162 per 1000 children during the first 2 years of life; approximately 40% required >1 day of medical attention with a mean duration of 7.0 ± 5.9 days. Prematurity was associated with increased risk of bronchiolitis episodes and longer duration. Bronchiolitis episodes rates per 1000 infants were 246 for 32–33 weeks gestational age, 204 for 34–36 weeks, and 148–178 for >36 weeks. Male gender, African-American and Hispanic race/ethnicity, and parental history of asthma were associated with an increased risk of having a bronchiolitis episode and/or longer duration.

Conclusions

Bronchiolitis episodes of care are frequent during the first two years of life and the duration ranges from 1 to 27 days. Prematurity was associated with more frequent and longer duration of bronchiolitis episodes of care, which may reflect illness severity and/or perceived vulnerability.
Zusatzmaterial
Additional file1: Online-Only Material Sensitivity Analyses (DOC 153 KB)
12913_2011_2030_MOESM1_ESM.doc
Authors’ original file for figure 1
12913_2011_2030_MOESM2_ESM.pdf
Authors’ original file for figure 2
12913_2011_2030_MOESM3_ESM.pdf
Literatur
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