Factors associated with length to recover adequate nutrition and length
of stay in children hospitalized for bronchiolitis: a retrospective
study.
Abstract
Context: Inadequate feeding is a frequent reason for hospital referring
in children with bronchiolitis and leads to prolonged hospitalization in
26% of the cases. The main objective was to identify the factors
associated with the time to recover adequate nutrition in infants
hospitalized for bronchiolitis. Method: We conducted a single-center
retrospective study including infants less than 12 months hospitalized
for bronchiolitis at Le Havre Hospital (France) between September 2018
and February 2021. A multivariate logistic regression model was computed
to investigate the factors associated with (1) the time to recover
adequate feeding (LOFR), and (2) the hospital length of stay (LOS).
Results: 268 infants were included to assess the LOFR and 478 infants to
assess the LOS. The median age was 3.2 months (1.6-5.4) and the sex
ratio M/F was 11/20. The use of accessory muscles, nutritional support,
and RR ≥ 70/min or < 30/min or apnea are associated (OR=1.5),
from virtually no association (OR=1.0) to a significant positive
association (OR=2.6) with the LOFR. Intense use of accessory muscles
(OR=3.9; 95%CI 1.6-10.4) and “severe” clinical condition (OR=2.8;
95%CI 1.7-4. 8) at admission, O2 supplementation (OR=2.0; 95%CI
1.3-3.1) were significantly related to prolonged LOS in the multivariate
analysis. Conclusion: The clinical severity on admission may be related
to the LOFR, ranging from none to significant. Other known factors and
the new clinical severity scale proposed by the latest French guidelines
appeared to be related to the LOS in this work. Further studies are
needed to highlight these factors.