The Turkish Journal of Pediatrics 2011 , Vol 53 , Num 6
Risk Factors Associated with Hospital Admission among Healthy Children with Adenovirus Infection
1Section of Pediatric Cardiology and Critical Care, and 6Biostatistics Program, Department of Pediatrics, 3Department of Ophthalmology, University of Arkansas Medical Center, Little Rock, Arkansas, and 2Division of Pediatric Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, and 4,5Departments of Anesthesiology and Pediatrics, Nationwide Children’s Hospital and the Ohio State University, Columbus, Ohio, and 7Department of Medical Education, Stanford University Medical Center, Palo Alto, California, USA Gupta P, Goyal S, Tobias JD, Prodhan P, Purohit P, Gossett JM, Chow V, Noviski N. Risk factors associated with hospital admission among healthy children with adenovirus infection. Turk J Pediatr 2011; 53: 597-603. Adenovirus infections mimic bacterial infections on initial presentation in healthy children, leading to higher likelihood of hospital admission. The objective of this study was to identify risk factors associated with hospital admission in previously healthy children with adenovirus infection. This is a retrospective study of 125 previously healthy children, who tested positive with direct immunofluorescence assay (DFA) for adenoviral infection at our center between January 2001 and October 2007. The primary outcome of the study was the need for hospital admission. The relationship between clinical variables at initial emergency room (ER) presentation and need for hospital admission were explored using univariate and multivariate logistic regression models. The model’s predictive value was investigated by calculating the area under the receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test. On stepwise multivariate logistic regression analysis, the presence of respiratory distress (odds ratio [OR]: 5.6; p=0.014), acute gastroenteritis (OR: 3.8; p=0.019) and wheezes at initial presentation (OR: 6.5; p=0.003) at the time of initial presentation in the ER were associated with need for hospital admission. For this model, the area under the ROC curve was 0.79, and there was no evidence of lack of fit on Hosmer-Lemeshow goodness-of-fit test (p=0.56). Our study identifies three risk factors, namely, respiratory distress, wheezing and acute gastroenteritis, associated with hospital admission for healthy children with adenoviral infections. Keywords : adenovirus, hospital admission, respiratory distress, wheezing, acute gastroenteritis.
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