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 were developed.Our primary aim was to determine the risk factors for longer pediatric intensive care unit (PICU) stay in term-born bronchiolitis patients who needed intensive care before 3-years old.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 ≤ 3-years, admitted to three tertiary-level PICU's in Ankara, during epidemic season with clinical diagnosis of bronchiolitis.Patients who were born preterm and who have congenital heart diseases, were excluded.The PRESS was used to define clinical severity of Bronchiolitis at admission.RESULTS: 53 of 79 (67.01%) were male and the median age was 6-months.Correlation analysis showed that PRISM-3 score (r:0.37),prenatal smoke exposure (r:0.34) and previous hospitalization (r:0.28) were associated significantly with longevity of PICU stay.Multiple regression analysis showed that only prenatal smoke exposure was related with longer PICU stay (R-sq:0.321).PRESS severity levels have no statistically important effect on PICU or hospital stay.CONCLUSION: Prenatal smoke exposure is the only independent risk factor for longer stay in intensive care for term-born bronchiolitis patients under age 3.