Risk factors for intensive care and respiratory support among infants with bronchiolitis

Abstract

The aim was to evaluate the risk factors for intensive care and for need of respiratory support in infants admitted for bronchiolitis at age less than 12 months.

This is a retrospective descriptive case-control study on 80 bronchiolitis (age-specific population 1.4/1000/year) patients treated in pediatric intensive care unit (PICU) and 160 controls treated in the emergency department (ED) or at the ward in Tampere University Hospital, between 2000-2012. A structured form was used to collect medical data of cases and controls separately in the ED, at the ward and in the PICU. Statistically significant risk factors in non-adjusted analyses were included in the adjusted logistic regression.

Age < 2 months (adjusted OR 7.0, 95%CI 2.7-18.5), low birth weight (< 2000 g) (adjusted OR 10.7, 95%CI 1.8-64.2), congenital heart disease (adjusted OR 8.5, 95%CI 2.3-31.7), and presence of apneas (adjusted OR 17.9, 95%CI 1.4-223.4) were significant risk factors for the intensive care. Significant risk factors for the need of respiratory support (mechanical ventilation or nasal CPAP) were age < 2 months (adjusted OR 8.5, 95%CI 2.4-30.7), low birth weight (< 2000 g) (adjusted OR 5.8, 95%CI 1.2-28.9) and congenital heart disease (adjusted OR 14.0, 95%CI 3.0-65.6), but not anymore presence of apneas (adjusted OR 2.7, 95%CI 0.4-17.6).

Less than 0.25% of infants needed intensive care for bronchiolitis at age less than 12 months. Half (49%) of those treated in the PICU were born prematurely. Low age, low birth weight and congenital heart disease were independently significant risk factors for both intensive care and respiratory support.