Abstract
Background: A prospective study estimated that 64% of children with bronchiolitis tested positive for respiratory syncytial virus (RSV), however, no studies have examined frequency or predictors of RSV testing.
Objective: To determine rates and predictors of RSV testing during bronchiolitis care episodes.
Design/methods: Retrospective cohort study involving 125,031 infants ≥32 weeks gestation born at 6 Kaiser Permanente hospitals 1996-2002. We defined an episode as a time period that:
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1) included selected diagnosis codes (e.g., 466.1 acute bronchiolitis),
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2) began with a related diagnosis code 2 days prior to a specific bronchiolitis code, and
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3) ended with a relevant diagnosis code followed by 14 clear days.
Results: Of 21,789 bronchiolitis episodes of care in our cohort, 4275 (19.6%) had at least one test for RSV. In multivariate analyses, gestational age 34-36 weeks, hospitalization status, and length of episode between 2-13 days predicted testing status, with adjusted odds ratios of 1.23 (95%CI, 1.07, 1.41), 17.6 (15.3, 20.1) and 3.49 (3.20, 3.80), respectively. Overall, 45.5% of RSV tests were positive.
Conclusions: Only a small portion of infants with bronchiolitis are tested for RSV, leading to an underdiagnosis of RSV by approximately 80%. The strongest predictors of testing status are episode length and whether the episode includes a hospitalization.
The study was sponsored by MedImmune.
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Escobar, G., Flaherman, V., Ragins, A. et al. 179 Testing for Respiratory Syncytial Virus During Bronchiolitis Care Episodes in An Integrated Health Care Delivery System. Pediatr Res 68 (Suppl 1), 93–94 (2010). https://doi.org/10.1203/00006450-201011001-00179
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DOI: https://doi.org/10.1203/00006450-201011001-00179