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Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute

Abdul R Shahein1, J Antonio Quiros2, Ricardo A Arbizu2

  • 1Division of Pediatric Gastroenterology and Nutrition, Children's Hospital of Arkansas, Little Rock, AR, USA.

Pediatric Gastroenterology, Hepatology & Nutrition
|July 25, 2020
PubMed

Insights

Elevated blood urea nitrogen (BUN) and persistent tachycardia indicate longer hospital stays in children with acute pancreatitis (AP). Fluid resuscitation also impacts length of stay (LOS).

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Research
  • Medical Informatics

Background:

  • Acute pancreatitis (AP) in children lacks validated severity markers.
  • Existing consensus guidelines for AP management may not be sufficient.
  • Identifying reliable indicators of severity is crucial for pediatric AP care.

Purpose of the Study:

  • To assess clinical and laboratory variables impacting hospital length of stay (LOS) in pediatric AP.
  • To evaluate the effect of treatment modality on LOS as a proxy for severity.
  • To determine the validity of current severity assessment in pediatric AP.

Main Methods:

  • Retrospective chart review of pediatric patients (0-18 years) with AP.
  • Data collected from two children's hospitals between 2013-2018.
  • Linear regression models analyzed organ dysfunction signs, lab markers, and fluid intake effects on LOS.

Main Results:

  • Ninety-two pediatric AP patients were analyzed; median LOS was 3 days.
  • Elevated blood urea nitrogen (BUN) on admission was linked to increased LOS (p<0.005).
  • Persistent tachycardia (≥48 hours) and need for fluid resuscitation correlated with longer LOS.

Conclusions:

  • Elevated BUN, persistent tachycardia, and fluid resuscitation are associated with increased LOS in pediatric AP.
  • Aggressive fluid intake above maintenance did not significantly reduce LOS.
  • These findings highlight key markers for assessing severity in pediatric acute pancreatitis.
Abstract

Keywords:
Fluid therapyLength of stayPancreatitis

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