Effect of prematurity on respiratory syncytial virus hospital resource use and outcomes.

OBJECTIVES: To determine if gestational age (GA) is independently associated with hospital resource use and outcomes among infants hospitalized for respiratory syncytial virus (RSV).

STUDY DESIGN: Analysis of retrospective data from 304 infants (</=1 year) with bronchiolitis or RSV pneumonia admitted to nine children's hospitals from April 1995 to September 1996. Resource use and outcomes examined included admission to the intensive care unit (ICU), intubation, and hospital and ICU length of stay. The Comprehensive Severity Index controlled for severity of illness.

RESULTS: Two hundred fifteen term infants (GA > or =37 weeks) and 89 infants with GA <37 weeks, divided according to GA into 3 subgroups (< or =32, 33 to 35, and 36 weeks), were compared. Significant differences were found for rate of intubation (P=.002) and ICU and hospital length of stay (P=.021 and P<.0001, respectively), with the highest resource use in 33 to 35 weeks GA infants, which remained significant in multiple regression analyses.

CONCLUSIONS: Infants 33 to 35 weeks GA had hospital outcomes that were negative or worse than infants < or =32 weeks GA. Data suggest prematurity < or =35 weeks GA significantly increases the risk for severe outcomes among infants hospitalized for RSV. Infants 36 weeks GA had outcomes similar to term infants. No evidence was observed of gradation or inverse linear risk relation between GA and hospital outcomes.