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Early Use of Anti-influenza Medications in Hospitalized Children With Tracheostomy
- Publication Year :
- 2019
- Publisher :
- American Academy of Pediatrics, 2019.
-
Abstract
- BACKGROUND: Early administration of anti-influenza medications is recommended for all children hospitalized with influenza. We investigated whether early use of anti-influenza medications is associated with improved outcomes in children with tracheostomy hospitalized with influenza. METHODS: We performed a multicenter retrospective cohort study through the Pediatric Health Information System database for patients aged 30 days to 19 years who were discharged between October 1, 2007, and September 30, 2015 with diagnostic codes for both influenza and tracheostomy. Our primary predictor was receipt of anti-influenza medications on hospital day 0 or 1. We used propensity score matching to adjust for confounding by indication. Primary outcomes were length of stay (LOS) and 30-day all-cause revisit rate (emergency department visit or hospital admission). RESULTS: Of 1436 discharges screened, 899 met inclusion criteria. The median admission age was 5 years (interquartile range: 2–10). The majority had multiple complex chronic conditions (median 3; interquartile range: 3–4) and technology dependence, such as gastrostomy tube (73.6%). After matching 772 unique admissions by propensity score, LOS was shorter for the cohort receiving early anti-influenza medications (6.4 vs 7.5 days; P = .01) without increase in revisit rate (27.5% vs 24.1%; P = .28). More than 80% in both cohorts received empirical antibiotics, and the duration of antibiotic therapy was similar (5.0 vs 5.6 days; P = .11). CONCLUSIONS: Early use of anti-influenza medications in children with tracheostomy hospitalized with influenza is associated with shorter LOS, but these children continue to receive antibiotics despite identification and treatment of their viral infections.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Time Factors
Adolescent
Antiviral Agents
Article
Cohort Studies
03 medical and health sciences
Young Adult
0302 clinical medicine
Tracheostomy
Interquartile range
030225 pediatrics
Epidemiology
Influenza, Human
Medicine
Humans
Child
Retrospective Studies
business.industry
Infant
Retrospective cohort study
Emergency department
Child, Preschool
Pediatrics, Perinatology and Child Health
Cohort
Propensity score matching
Female
Diagnosis code
business
Child, Hospitalized
Cohort study
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....8cd197abf8a559887bb534bd93c26658