Viral lower respiratory tract infections—strict admission guidelines for young children can safely reduce admissions

Viral lower respiratory tract infection (VLRTI) is the most common cause of hospital admission among small children in high-income countries. Guidelines to identify children in need of admission are lacking in the literature. In December 2012, our hospital introduced strict guidelines for admission....

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Bibliographic Details
Published in:European journal of pediatrics 2021-08, Vol.180 (8), p.2473-2483
Main Authors: Havdal, Lise Beier, Nakstad, Britt, Fjærli, Hans Olav, Ness, Christian, Inchley, Christopher
Format: Article
Language:English
Subjects:
Adverse events
Bronchiolitis
Bronchopneumonia
Child
Child, Preschool
Children
Emergency medical care
Emergency Service, Hospital
Hospitalization
Humans
Infant
Infections
Medicine
Medicine & Public Health
Original
Original Article
Patient Discharge
Pediatrics
Respiratory tract diseases
Respiratory tract infection
Retrospective Studies
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Summary:Viral lower respiratory tract infection (VLRTI) is the most common cause of hospital admission among small children in high-income countries. Guidelines to identify children in need of admission are lacking in the literature. In December 2012, our hospital introduced strict guidelines for admission. This study aims to retrospectively evaluate the safety and efficacy of the guidelines. We performed a single-center retrospective administrative database search and medical record review. ICD-10 codes identified children < 24 months assessed at the emergency department for VLRTI for a 10-year period. To identify adverse events related to admission guidelines implementation, we reviewed patient records for all those discharged on primary contact followed by readmission within 14 days. During the study period, 3227 children younger than 24 months old were assessed in the ED for VLRTI. The proportion of severe adverse events among children who were discharged on their initial emergency department contact was low both before (0.3%) and after the intervention (0.5%) ( p =1.0). Admission rates before vs. after the intervention were for previously healthy children > 90 days 65.3% vs. 53.3% ( p
ISSN:0340-6199
1432-1076
DOI:10.1007/s00431-021-04057-4