A validated clinical model to predict the need for admission and length of stay in children with acute bronchiolitis.

Paul Walsh, Stephen J. Rothenberg, Sinead O'Doherty, Hilary Hoey, Roisin Healy

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

OBJECTIVE: To develop and validate a logistic regression model to predict need for admission and length of hospital stay in children presenting to the Emergency Department with bronchiolitis. SETTING: Two children's hospitals in Dublin, Ireland. METHODS: We reviewed 118 episodes of bronchiolitis in 99 children admitted from the Emergency Department. Those discharged within 24 h by a consultant/attending paediatrician were retrospectively categorized as suitable for discharge. We then validated the model using a cohort of 182 affected infants from another paediatric Emergency Department in a bronchiolitis season 2 years later. In the validation phase actual admission, failed discharge, and age less than 2 months defined the need for admission. RESULTS: The model predicted admission with 91% sensitivity and 83% specificity in the validation cohort. Age [odds ratio (OR) 0.86, 95% confidence interval (CI) 0.76-0.97], dehydration (OR 2.54, 95% CI 1.34-4.82), increased work of breathing (OR 3.39, 95% CI 1.29-8.92) and initial heart rate above the 97th centile (OR 3.78, 95% CI 1.05-13.57) predicted the need for admission and a longer hospital stay. CONCLUSION: We derived and validated a severity of illness model for bronchiolitis. This can be used for outcome prediction in decision support tools or severity of illness stratification in research/audit.

Original languageEnglish (US)
Pages (from-to)265-272
Number of pages8
JournalEuropean journal of emergency medicine : official journal of the European Society for Emergency Medicine
Volume11
Issue number5
StatePublished - Oct 2004
Externally publishedYes

Fingerprint

Bronchiolitis
Length of Stay
Odds Ratio
Confidence Intervals
Hospital Emergency Service
Logistic Models
Work of Breathing
Consultants
Dehydration
Ireland
Heart Rate
Pediatrics
Sensitivity and Specificity
Research

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

A validated clinical model to predict the need for admission and length of stay in children with acute bronchiolitis. / Walsh, Paul; Rothenberg, Stephen J.; O'Doherty, Sinead; Hoey, Hilary; Healy, Roisin.

In: European journal of emergency medicine : official journal of the European Society for Emergency Medicine, Vol. 11, No. 5, 10.2004, p. 265-272.

Research output: Contribution to journalArticle

@article{53130745890c4cc4a4247457735ca904,
title = "A validated clinical model to predict the need for admission and length of stay in children with acute bronchiolitis.",
abstract = "OBJECTIVE: To develop and validate a logistic regression model to predict need for admission and length of hospital stay in children presenting to the Emergency Department with bronchiolitis. SETTING: Two children's hospitals in Dublin, Ireland. METHODS: We reviewed 118 episodes of bronchiolitis in 99 children admitted from the Emergency Department. Those discharged within 24 h by a consultant/attending paediatrician were retrospectively categorized as suitable for discharge. We then validated the model using a cohort of 182 affected infants from another paediatric Emergency Department in a bronchiolitis season 2 years later. In the validation phase actual admission, failed discharge, and age less than 2 months defined the need for admission. RESULTS: The model predicted admission with 91{\%} sensitivity and 83{\%} specificity in the validation cohort. Age [odds ratio (OR) 0.86, 95{\%} confidence interval (CI) 0.76-0.97], dehydration (OR 2.54, 95{\%} CI 1.34-4.82), increased work of breathing (OR 3.39, 95{\%} CI 1.29-8.92) and initial heart rate above the 97th centile (OR 3.78, 95{\%} CI 1.05-13.57) predicted the need for admission and a longer hospital stay. CONCLUSION: We derived and validated a severity of illness model for bronchiolitis. This can be used for outcome prediction in decision support tools or severity of illness stratification in research/audit.",
author = "Paul Walsh and Rothenberg, {Stephen J.} and Sinead O'Doherty and Hilary Hoey and Roisin Healy",
year = "2004",
month = "10",
language = "English (US)",
volume = "11",
pages = "265--272",
journal = "European Journal of Emergency Medicine",
issn = "0969-9546",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - A validated clinical model to predict the need for admission and length of stay in children with acute bronchiolitis.

AU - Walsh, Paul

AU - Rothenberg, Stephen J.

AU - O'Doherty, Sinead

AU - Hoey, Hilary

AU - Healy, Roisin

PY - 2004/10

Y1 - 2004/10

N2 - OBJECTIVE: To develop and validate a logistic regression model to predict need for admission and length of hospital stay in children presenting to the Emergency Department with bronchiolitis. SETTING: Two children's hospitals in Dublin, Ireland. METHODS: We reviewed 118 episodes of bronchiolitis in 99 children admitted from the Emergency Department. Those discharged within 24 h by a consultant/attending paediatrician were retrospectively categorized as suitable for discharge. We then validated the model using a cohort of 182 affected infants from another paediatric Emergency Department in a bronchiolitis season 2 years later. In the validation phase actual admission, failed discharge, and age less than 2 months defined the need for admission. RESULTS: The model predicted admission with 91% sensitivity and 83% specificity in the validation cohort. Age [odds ratio (OR) 0.86, 95% confidence interval (CI) 0.76-0.97], dehydration (OR 2.54, 95% CI 1.34-4.82), increased work of breathing (OR 3.39, 95% CI 1.29-8.92) and initial heart rate above the 97th centile (OR 3.78, 95% CI 1.05-13.57) predicted the need for admission and a longer hospital stay. CONCLUSION: We derived and validated a severity of illness model for bronchiolitis. This can be used for outcome prediction in decision support tools or severity of illness stratification in research/audit.

AB - OBJECTIVE: To develop and validate a logistic regression model to predict need for admission and length of hospital stay in children presenting to the Emergency Department with bronchiolitis. SETTING: Two children's hospitals in Dublin, Ireland. METHODS: We reviewed 118 episodes of bronchiolitis in 99 children admitted from the Emergency Department. Those discharged within 24 h by a consultant/attending paediatrician were retrospectively categorized as suitable for discharge. We then validated the model using a cohort of 182 affected infants from another paediatric Emergency Department in a bronchiolitis season 2 years later. In the validation phase actual admission, failed discharge, and age less than 2 months defined the need for admission. RESULTS: The model predicted admission with 91% sensitivity and 83% specificity in the validation cohort. Age [odds ratio (OR) 0.86, 95% confidence interval (CI) 0.76-0.97], dehydration (OR 2.54, 95% CI 1.34-4.82), increased work of breathing (OR 3.39, 95% CI 1.29-8.92) and initial heart rate above the 97th centile (OR 3.78, 95% CI 1.05-13.57) predicted the need for admission and a longer hospital stay. CONCLUSION: We derived and validated a severity of illness model for bronchiolitis. This can be used for outcome prediction in decision support tools or severity of illness stratification in research/audit.

UR - http://www.scopus.com/inward/record.url?scp=16644364483&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=16644364483&partnerID=8YFLogxK

M3 - Article

C2 - 15359199

AN - SCOPUS:16644364483

VL - 11

SP - 265

EP - 272

JO - European Journal of Emergency Medicine

JF - European Journal of Emergency Medicine

SN - 0969-9546

IS - 5

ER -