Factors affecting Severe Acute Bronchiolitis in Children at Mukdahan Hospital

Abstract

Background: Acute bronchiolitis in children is a common disease that requires hospitalization. Understanding the factors that affect severe acute bronchiolitis in children will enable more effective monitoring and treatment.

Objective: To determine the factors affecting severe acute bronchiolitis in children and clinical characteristics.

Methods: This was a retrospective observational study of children aged 1 month to 60 months who were first hospitalized with acute bronchiolitis at Mukdahan Hospital from 1 October 2022 to 31 October 2024. The Chi-square test and multivariable ordinal logistic regression analysis were used to compare outcomes from three groups: those with mild symptoms (non-oxygen treatment), moderate symptoms (oxygen cannula or mask), and severe symptoms (high-flow nasal cannula or endotracheal intubation).

Results: Of 499 pediatric patients with acute bronchiolitis, 89 (17.8%) required high-flow nasal cannula oxygen or endotracheal intubation. Most patients were male (63.9%), and 45.9% were aged 1 to 12 months. Multivariate analysis showed that significant factors for severe acute bronchiolitis included age 13-24 months (OR 3.7; 95% CI 1.2-11.4; p 0.024), age 25-36 months (OR 4.8; 95% CI 1.5-15.4; p 0.007), and duration of illness before hospital admission 1-3 days (OR 2.4; 95% CI 1.1-5.3; p 0.037).

Conclusion: Pediatric patients with acute bronchiolitis should be closely monitored, especially those aged between 13-24 months, 25-36 months, and those with a pre-hospital illness period of 1-3 days.