Epidemiology and Outcome Trends of Hospitalized Infants With RSV Bronchiolitis During 1997-2016
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Pediatrics, Worldwide Data, 2022
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INTRODUCTION: Respiratory syncytial virus (RSV) is the most common viral infection in infants. The aims of this study were to describe the epidemiology and to analyze the trends in prevalence, the presence of complex chronic condition (CCC), and use of invasive mechanical ventilation (IMV), and mortality rate in infants that required hospitalization for RSV infection during 1997 to 2016. 
METHODS: A retrospective analysis of the Healthcare Cost and Utilization Project’s Kids’ inpatient Database from 1997 to 2016 was performed. RSV infection in the age group 29 days to 1 year was identified with the use of appropriate ICD 9 and 10 codes. Demographic and outcome data were compared between infants with and without RSV infection (SPSS, IBM). Trend analyses were performed using StatCalc (Epi Info, CDC). 
RESULTS: A total of 416,723 (5.5%) of 7,544,391 hospital discharges during infancy represented RSV bronchiolitis. Infants with RSV bronchiolitis were predominantly male (58%), white (47.5%) and 3.8% had an associated CCC. Most children were discharged during Jan-Mar (62%) and least during July-Sept (2.2%). RSV bronchiolitis discharges were relatively more frequent in the midwest and west compared to other discharges (p < 0.05). The use of IMV ranged from 2.5% in 1997 to 5% in 2016 (p < 0.001). Associated CCC was present in 3.7% in 1997 and increased to 7.5% in 2016 (p < 0.001). The mortality rate in all RSV infants decreased from 0.12% in 1997 and to 0.06% in 2012 (p < 0.05). IMV was used in 3.2% of infants with RSV bronchiolitis compared to 20.1% of those with CCC (OR:9.8, 95%CI:9.4-10.2; p < 0.001). The mortality rate for RSV bronchiolitis was significantly higher with the presence of CCC (1.57% vs 0.03%; OR 51.4, 95%CI: 41.4-63.8; p < 0.001). The use of IMV increased and the mortality rate decreased in infants with RSV and CCC during the study period (p < 0.05). 
CONCLUSION:This large national cohort study shows that the prevalence of RSV bronchiolitis, the presence of CCC and the use of IMV increased from 1997 to 2016 in infants hospitalized with RSV bronchiolitis while mortality decreased. The presence of CCC is associated with increased use of IMV and mortality. There are seasonal and regional variation in hospitalization rates for infants with bronchiolitis.
Meta Tag
Content Type Presentation
Knowledge Area Pediatrics
Knowledge Area Worldwide Data
Knowledge Level Intermediate
Knowledge Level Advanced
Membership Level Select
Tag Respiratory Syncytial Virus RSV
Tag Epidemiology Outcomes
Tag Airway Management
Tag Mortality
Year 2022
RSV bronchiolitis
mortality rate


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