Risk Factors of Long PICU Stay for Term-Born Bronchiolitis Patients Less than 3 Years Old

BACKGROUND/AIMS: Bronchiolitis, which is caused by a virus, is the most common lower respiratory infection in children aged <3 years. Several prenatal and postnatal risk factors affect the need for escalated care. To standardize the assessment of these patients, scoring systems based on clinical findings and respiratory examinations have been developed. Our primary aim was to determine the risk factors for longer pediatric intensive care unit (PICU) stays in term-born bronchiolitis patients who needed intensive care before 3 -years of age. Our secondary aim was to evaluate the efficacy of the Pediatric Respiratory Severity Score (PRESS) scoring system. MATERIALS AND METHODS: A prospective observational study was performed on pediatric patients aged s3 -years who had been admitted to three tertiary-le vel PICUs in Ankara, during the epidemic season with clinical diagnoses of bronchiolitis. Those patients who were born preterm or who had congenital heart diseases were excluded. PRESS was used to define the clinical severity of bronchiolitis at admission. RESULTS: Fifty three of the 79 (67.01%) were male and the median age was 6-months. Correlation analysis showed that Pediatric Risk of Mortality III Score (r=0.37), prenatal smoke exposure (r=0.34) and previous hospitalization (r=0.28) were significantly associated with the length of PICU stay. Multiple regression analysis showed that only prenatal smoke exposure was related with longer PICU stays (R-sq: 0.321). PRESS severity levels had no statistically significant effect on PICU or hospital stays. CONCLUSION: Prenatal smoke exposure is the only independent risk factor for longer stays in intensive care units for term-born bronchiolitis patients under 3 years of age.