Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respiratory syncytial viral lower respiratory tract infection - 12/10/17
Abstract |
OBJECTIVES: To describe differences in patients hospitalized with respiratory syncytial virus (RSV) lower respiratory tract infection (LRI) at nine Canadian tertiary care hospitals. In addition, this study describes the variation in use of drug and other interventions. METHODS: Data on patients hospitalized with RSV LRI and their outcomes were prospectively collected. Demographic data were obtained on enrollment by center study nurses. Data recorded daily included clinical assessment, oxygen saturation determination, and interventions (bronchodilators, steroids, ribavirin, antibiotics, intensive care, and mechanical ventilation) received during the day. Patients were divided into those with underlying diseases including congenital heart disease, chronic lung disease, immunodeficiency, or multiple congenital anomalies and those who were previously healthy. Mean RSV-associated length of stay and the proportion of patients receiving each intervention in each group were determined by hospital. RESULTS: A total of 1516 patients were enrolled at nine hospitals during January 1 to June 30, 1993, and January 1 to April 30, 1994. Significant differences were observed among hospitals in the proportion of patients with underlying disease, postnatal age less than 6 weeks, hypoxia, and pulmonary infiltrate on chest radiograph. The mean length of stay varied among hospitals from 8.6 to 11.8 days and 4.6 to 6.7 days in compromised and previously healthy patients, respectively. Except for receipt of bronchodilators, compromised patients were significantly more likely to receive interventions than previously healthy patients. There was variation among hospitals in receipt of most interventions in compromised and previously healthy patients. This variation was statistically significant for previously healthy patients but not statistically significant in those with underlying disease, because the numbers of patients in the latter group were much smaller. The magnitude of the variation for each intervention, however, was not different between those with underlying disease compared with previously healthy patients. CONCLUSION: Differences exist among tertiary pediatric hospitals in the nature of the patients admitted with RSV LRI. Variation occurred in the use of five interventions among the hospitals, regardless of whether the patient had underlying illness or was previously healthy. Given their current widespread use, high cost, and potential side effects, randomized clinical trials are needed to determine the efficacy of different drug treatments used to treat infants hospitalized with RSV. (J PEDIATR 1996;129:390-5)
Le texte complet de cet article est disponible en PDF.Abbreviations : RSV, LRI, CI
Plan
 | From the Departments of Pediatrics at the Hospital for Sick Children and University of Toronto, Ontario; Winnipeg Children's Hospital and University of Manitoba, Winnipeg; Centre Hospitalier de l'Université Laval and l'Université Laval, Quebec City, Quebec; University of Alberta Hospital and University of Alberta, Edmonton; British Columbia's Children's Hospital and University of British Columbia, Vancouver; Izaak Walton Killam Hospital and Dalhousie University, Halifax, Nova Scotia; Montreal Children's Hospital and McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario; and Alberta Children's Hospital and University of Calgary, Calgary, Alberta |
| Supported by a grant from Lederle Praxis Biologicals Inc., West Henrietta, N.Y. |
 | Reprint requests: Elaine E. L. Wang, MD, Clinical Epidemiology Unit, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1X8, Canada. |
| 0022-3476/96/$5.00 + 0 9/21/75043 |
Vol 129 - N° 3
P. 390-395 - septembre 1996 Retour au numéro
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