Inpatient hospitalizations for croup

Area of Science:

• Pediatrics
• Respiratory Medicine
• Critical Care

Background:

• Croup is a frequent pediatric respiratory illness causing significant morbidity.
• Hospitalization for croup necessitates understanding factors influencing treatment duration and outcomes.

Purpose of the Study:

• To identify characteristics associated with prolonged inpatient treatment and extended length of stay (LOS) in children hospitalized with croup.
• To evaluate the utilization of racemic epinephrine and systemic corticosteroids in hospitalized croup patients.

Main Methods:

• Retrospective review of 365 hospitalizations for croup between 2006-2010.
• Inclusion criteria: diagnosis of croup, administration of racemic epinephrine or systemic corticosteroids.
• Exclusion criteria: incomplete medication or vital sign data.

Main Results:

• Of 327 patients, 49% received post-hospitalization racemic epinephrine and 48% received systemic corticosteroids.
• Demographics, past history, or initial vital signs did not predict the need for post-hospitalization racemic epinephrine.
• History of croup, prior intubation, or presenting oxygen saturation <95% were linked to increased LOS (P < .05).

Conclusions:

• A significant proportion (51%) of hospitalized croup patients did not require inpatient racemic epinephrine.
• Predictors of a prolonged or complicated hospital course include lower initial oxygen saturation and a history of croup or intubation.