Bronchiolitis Treatment in Infants Varies by Hospital

HealthDay News — For infants with bronchiolitis, the use of evidence-based supportive therapies (EBSTs) varies by hospital site, according to a study published in Pediatrics.

Suzanne Schuh, MD, from the Hospital for Sick Children in Toronto, and colleagues conducted a retrospective study involving previously health infants aged <12 months with bronchiolitis. Data were included for 3725 infants.

The researchers found that 39% of the patients were hospitalized and 69.8% of those hospitalized received EBST. There was variation in EBST use by site (range, 6% to 99%; P < .001), but not by network (P =.2). Significant multivariable predictors included age (odds ratio [OR], 0.9), oxygen saturation (OR, 1.3), apnea (OR, 3.4), dehydration (OR, 3.2), nasal flaring/grunting (OR, 2.4), poor feeding (OR, 2.1), chest retractions (OR, 1.9), and respiratory rate (OR, 1.2). 

There was variation in pharmacotherapy and radiography use by network and site (P <.001), with intersite ranges from 2% to 79% and 1.6% to 81%, respectively. The multivariable OR for use of pharmacotherapy was 22.7 in Spain and Portugal, 11.5 in Canada, 6.8 in the United States, and 1.4 in the United Kingdom, compared with Australia and New Zealand.

“The hospital site was a source of variation in all study outcomes, and the network also predicted the use of pharmacotherapy and radiography,” the authors write.

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Schuh S, Babl FE, Dalziel SR, et al. Practice variation in acute bronchiolitis: a pediatric emergency research networks study [published November 2017]. Pediatrics. doi: 10.1542/peds.2017-0842