Hospital course and discharge criteria for children hospitalized with bronchiolitis.

摘要: BACKGROUND For children hospitalized with bronchiolitis, there is uncertainty about the expected inpatient clinical course and when are safe for discharge. OBJECTIVES Examine time to improvement, risk of worsening after develop discharge criteria. DESIGN Prospective multiyear cohort study. SETTING Sixteen US hospitals. PARTICIPANTS Consecutive age <2 years bronchiolitis. MEASUREMENT We defined improvement using: (1) retraction severity, (2) respiratory rate, (3) room air oxygen saturation, (4) hydration status. After meeting criteria, were considered clinically worse based on inverse ≥1 these criteria or need intensive care. RESULTS Among 1916 children, median number days from onset difficulty breathing until was 4 (interquartile range, 3-7.5 days). Of total, 1702 (88%) met 4% (3% required care). Children who worsened months (adjusted odds ratio [AOR]: 3.51; 95% confidence interval [CI]: 2.07-5.94), gestational <37 weeks (AOR: 1.94; CI: 1.13-3.32), presented severe retractions 5.55; 2.12-14.50), inadequate oral intake 2.54; 1.39-4.62), apnea 2.87; 1.45-5.68). Readmissions similar did not worsen. CONCLUSIONS Although bronchiolitis had wide-ranging recovery times, only initial improvement. more likely be younger, premature infants presenting in distress. data may help establish evidence-based reduce practice variability, safely shorten hospital length-of-stay.