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Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma.

Publication ,  Journal Article
Shein, SL; Rotta, AT; Speicher, R; Slain, KN; Gaston, B
Published in: Hosp Pediatr
July 2017

BACKGROUND AND OBJECTIVE: Meta-analyses show that corticosteroids are not effective in patients with bronchiolitis. However, risk factors for asthma such as eczema or familial atopy prompt some practitioners to prescribe corticosteroids for bronchiolitis. We assessed if corticosteroid prescription is associated with shorter hospitalization for bronchiolitis among patients who later develop asthma. METHODS: The Pediatric Health Information System database was interrogated for patients with bronchiolitis aged <2 years hospitalized between 2006 and 2015. Only patients who also later had a hospitalization for asthma and prescription of inhaled corticosteroids were included. For the initial bronchiolitis admission, use of mechanical ventilation defined "severe illness," and ICU admission without mechanical ventilation defined "moderate illness"; all other patients were deemed to have "mild illness." Variables associated (P < .10) with length of stay (LOS) in bivariate analysis were included in linear regression analysis. RESULTS: During the bronchiolitis admission of 2479 children who were later hospitalized for asthma, corticosteroid prescription (n = 857) was associated with longer LOS in bivariate analysis (3 [2-4] vs 2 [2-4] days; P < .01) but not the multivariate model (P = .18) that included age, sex, comorbid conditions, bacterial pneumonia, and illness severity. Corticosteroid prescription was associated with shorter LOS among previously healthy children with moderate illness (4 [2-6] vs 5 [3-7] days; P = .02) but not those with mild or severe illness. CONCLUSIONS: Corticosteroids were not associated with improved outcome in patients with bronchiolitis who were later hospitalized with asthma. Moderately ill patients with no comorbidities may warrant further study.

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Published In

Hosp Pediatr

DOI

ISSN

2154-1663

Publication Date

July 2017

Volume

7

Issue

7

Start / End Page

403 / 409

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Pneumonia, Bacterial
  • Outcome and Process Assessment, Health Care
  • Male
  • Length of Stay
  • Infant
  • Humans
 

Citation

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Shein, S. L., Rotta, A. T., Speicher, R., Slain, K. N., & Gaston, B. (2017). Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma. Hosp Pediatr, 7(7), 403–409. https://doi.org/10.1542/hpeds.2016-0211
Shein, Steven L., Alexandre T. Rotta, Richard Speicher, Katherine N. Slain, and Benjamin Gaston. “Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma.Hosp Pediatr 7, no. 7 (July 2017): 403–9. https://doi.org/10.1542/hpeds.2016-0211.
Shein SL, Rotta AT, Speicher R, Slain KN, Gaston B. Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma. Hosp Pediatr. 2017 Jul;7(7):403–9.
Shein, Steven L., et al. “Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma.Hosp Pediatr, vol. 7, no. 7, July 2017, pp. 403–09. Pubmed, doi:10.1542/hpeds.2016-0211.
Shein SL, Rotta AT, Speicher R, Slain KN, Gaston B. Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma. Hosp Pediatr. 2017 Jul;7(7):403–409.

Published In

Hosp Pediatr

DOI

ISSN

2154-1663

Publication Date

July 2017

Volume

7

Issue

7

Start / End Page

403 / 409

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Pneumonia, Bacterial
  • Outcome and Process Assessment, Health Care
  • Male
  • Length of Stay
  • Infant
  • Humans