Factors associated with length of hospital stay in children with respiratory disease.

Objectives: To explore factors associated with length of stay, and secondarily to explore the potential of enhanced diagnostics to address respiratory disease burden in children.

Design: Prospective study.

Setting: A university teaching hospital in Hong Kong.

Patients: Data from 475 children with respiratory tract symptoms or fever admitted to Prince of Wales Hospital, Hong Kong from November 2005 to April 2007.

Main Outcome Measures: Aetiological diagnoses based on enhanced diagnostics and their association with clinical information.

Results: Data from 469 subjects showed that major presentations were fever (84%), cough (72%), and runny nose (64%). The median length of stay was longest (3 days) for adenovirus, metapneumovirus and mycoplasma infections, while children with negative aetiological results had a median length of stay of 2 days. Fever duration during admission (P<0.001), the highest recorded temperature during admission (P < 0.001), use of antibiotics during admission (P<0.001), ear pain before admission (P = 0.019), and high white cell counts (P = 0.021) were associated with increased length of stay (univariate analysis). Identifying an aetiological agent did not affect length of stay. Comparison of children with a positive immunofluorescence test result (rapidly available) with those in whom the test was negative though a positive multiplex polymerase chain reaction ensued (result not available to clinicians) also showed no association with length of stay.

Conclusion: Although rapid enhanced diagnostics may not have a major influence on length of stay, these data form an integral part of enhanced sentinel surveillance systems.