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Bronchiolitis risk of admission score is length of hospital stay predictor
SAN DIEGO — Bronchiolitis risk of admission score may predict length of stay and level of care among infants with acute bronchiolitis, according to data presented here.
Matko Marlais, MBBS, BSc, of Chelsea and Westminster Hospital in London, and colleagues applied the bronchiolitis risk of admission score to 163 infants who presented to the ED with acute bronchiolitis and required hospital admission. Mean age at ED presentation was 18 weeks. Bronchiolitis risk of admission score was applied at presentation to the ED.
Matko Marlais
“This is a second stage study. Initially a study was done on whether you could predict if a child with bronchiolitis needed to be admitted to the hospital or discharged using initial observations in the ED and clinical findings. We developed a 5-point score that was moderately predictive of their needs,” Marlais told Infectious Diseases in Children. “As a sort of second stage, in this study, we looked to see whether that score at the point of triage for those that were admitted could be used to assess their length of hospital stay and whether they would need additional respiratory support. In our unit that would be nasal continuous positive airway pressure.”
Mean length of hospital stay was 3 days, ranging from 1 to 30 days. Researchers found that bronchiolitis risk of admission score correlated with length of hospital stay (P<0.0001).
Infants who required a higher level of care, indicated by implementation of non-invasive ventilation via continuous nasal positive airway pressure, had a higher bronchiolitis risk of admission score compared with infants who required supportive care only (mean score 4.41 vs. 3.01; P<0.0001).
“We found that the score children have at the point of triage is linked to their length of hospital stay. There is a correlation with a higher score, generally these children will need a longer hospital stay. That’s useful in some ways because it means that these children will probably be admitted to our ward rather than our 24-hour observation unit; whereas a child who looks very well with a low score might be admitted to our observation unit. So from the point of planning the flow through the hospital it was quite helpful,” Marlais said.
Marlais noted that data indicated children with a higher score were more likely to need additional support, but the finding was not strong enough to make decisions on an individual basis.
“What we will probably be doing is using this score at the point of triage to determine whether children will need a bit of a longer stay and it helps us then manage their flow through the hospital,” he told Infectious Diseases in Children. — by Amanda Oldt
For more information:
Marlais M. #25623. Presented at: 2014 AAP National Conference and Exhibition; Oct. 11-14; San Diego.
Disclosure: Infectious Diseases in Children was unable to confirm financial disclosures.