Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb 26;9(2):e89186.
doi: 10.1371/journal.pone.0089186. eCollection 2014.

Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study

Joanna Murray  1 , Alex Bottle  1 , Mike Sharland  2 , Neena Modi  3 , Paul Aylin  1 , Azeem Majeed  1 , Sonia Saxena  1 ; Medicines for Neonates Investigator Group
Collaborators, Affiliations

Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study

Joanna Murray et al. PLoS One. .

Abstract

Objective: To examine the timing and duration of RSV bronchiolitis hospital admission among term and preterm infants in England and to identify risk factors for bronchiolitis admission.

Design: A population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics database.

Setting: 71 hospitals across England.

Participants: We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life.

Results: In our cohort there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95%CI 23.7-24.8), of which 15% (1050/7189) were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4-50.2)). The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61-209 days). The median length of stay was 1 day (IQR = 0-3). The relative risk (RR) of a bronchiolitis admission was higher among infants with known risk factors for severe RSV infection, including those born preterm (RR = 1.9, 95% CI 1.8-2.0) compared with infants born at term. Other conditions also significantly increased risk of bronchiolitis admission, including Down's syndrome (RR = 2.5, 95% CI 1.7-3.7) and cerebral palsy (RR = 2.4, 95% CI 1.5-4.0).

Conclusions: Most (85%) of the infants who are admitted to hospital with bronchiolitis in England are born at term, with no known predisposing risk factors for severe RSV infection, although risk of admission is higher in known risk groups. The early age of bronchiolitis admissions has important implications for the potential impact and timing of future active and passive immunisations. More research is needed to explain why babies born with Down's syndrome and cerebral palsy are also at higher risk of hospital admission with RSV bronchiolitis.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: We have the following interests: Unrestricted support for the Neonatal Data Analysis Unit from Abbott International and Danone UK is acknowledged. The Dr Foster Unit at Imperial are principally funded via a research grant by Dr Foster Intelligence, an independent healthcare information company and joint venture with the Information Centre of the NHS. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Figure 1
Figure 1. Age of bronchiolitis admission in months, for admissions coded as RSV or unspecified bronchiolitis.
Figure 2
Figure 2. Proportion of bronchiolitis hospital admissions among birth cohort, by Strategic Health Authority (SHA) of admission.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Barben J, Kuehni CE, Trachsel D, Hammer J (2008) Management of acute bronchiolitis: can evidence based guidelines alter clinical practice? Thorax 63: 1103–1109. - PubMed
    1. Bush A, Thomson AH (2007) Acute bronchiolitis. BMJ 335(7628): 1037–1041. - PMC - PubMed
    1. Deshpande SA, Northern V (2003) The clinical and health economic burden of respiratory syncytial virus disease among children under 2 years of age in a defined geographical area. Arch Dis Child 88(12): 1065–1069. - PMC - PubMed
    1. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, et al. (2010) Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. The Lancet 375(9725): 1545–1555. - PMC - PubMed
    1. Koehoorn M, Karr CJ, Demers PA, Lencar C, Tamburic L, et al. (2008) Descriptive Epidemiological Features of Bronchiolitis in a Population-Based Cohort. Pediatrics 122(6): 1196–1203. - PubMed

Publication types