Risk factors for re-hospitalization within 90 days of discharge for severe influenza in children.

Risk factors for re-hospitalization within 90 days of discharge for severe influenza in children.

Publication date: Jan 16, 2025

Influenza virus is a contagious respiratory pathogen that can cause severe acute infections with long-term adverse outcomes. For paediatric patients at high risk of severe influenza, the readmission and the associated risk factors remain unclear. Children discharged with a diagnosis of severe or critical influenza from October 2021 to March 2022 were included. The disease severity was categorized according to the “2020 edition of the Chinese expert consensus on the diagnosis and treatment of influenza in children”. Demographic data, clinical characteristics, underlying medical conditions, microbiology, treatment outcomes, and 90-day readmissions were retrieved and retrospectively analyzed. Those who tested positive for COVID-19 were excluded. Risk factors independently associated with readmission were identified using multiple logistic regression models. During the study period, 225 children with severe influenza were hospitalized and 14. 7% (33/225) of them were readmitted within 90 days. The median length of readmission was 62 (IQR, 31-76) days, and the most common cause of readmission was pneumonia. M. pneumoniae and influenza virus are the most common infections for readmission The children who were readmitted were more likely to have critical influenza and neurological comorbidities compared to patients without readmission. The readmitted children had a significantly higher proportion of natural killer cells and a shorter febrile duration and length of stay on their first admission, compared with those who were not readmitted. Rhinosinusitis (OR = 30. 085, p = . 008) and high level of natural killer cells (OR = 1. 107, p = . 012) were independent risk factors and febrile duration (OR, 0. 748, p = . 018) was a protective factor for 90-day readmission. Our findings suggest that, to reduce the potential readmission of children with severe influenza, a sustained focus on the risk factors including rhinosinusitis and over-activated host immune response during the index hospitalization is needed.

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Concepts Keywords
Chinese 90-day readmission
Expert Adolescent
Influenza Child
Microbiology Child, Preschool
Children
China
Female
Humans
Infant
Influenza, Human
Male
Patient Discharge
Patient Readmission
Retrospective Studies
Risk Factors
Severe influenza

Semantics

Type Source Name
disease MESH influenza
disease IDO pathogen
disease MESH infections
disease MESH COVID-19
disease MESH pneumonia
disease MESH Rhinosinusitis
disease IDO host
disease IDO immune response
pathway REACTOME Reproduction
disease MESH Infectious Diseases
drug DRUGBANK Coenzyme M
disease IDO acute infection
disease IDO infection
disease IDO assay
disease IDO nucleic acid
disease IDO blood
disease IDO bacteria
disease MESH bacterial infection
drug DRUGBANK Edetic Acid
drug DRUGBANK Fluorescein
pathway REACTOME Influenza Infection
disease MESH tachypnea
disease MESH dyspnea
disease MESH restlessness
disease MESH convulsions
disease MESH dehydration
disease MESH Critical illness
disease MESH respiratory failure
disease MESH encephalopathy
disease MESH septic shock
disease MESH complications
disease MESH digestive system disorders
disease MESH nervous system disorders
disease MESH myositis
disease MESH Death
disease MESH epilepsy
disease MESH meningitis
disease MESH intestinal obstruction
drug DRUGBANK Methionine
disease MESH congenital heart disease
disease MESH pectus excavatum
disease MESH asthma
pathway KEGG Asthma
pathway KEGG Primary immunodeficiency
disease IDO primary immunodeficiency
disease MESH febrile seizures
disease MESH Bronchiolitis
disease MESH Pleural effusion
drug DRUGBANK Medical air
disease MESH syndrome
disease MESH otitis media
disease IDO cell
disease MESH coinfection
disease MESH etiology
disease IDO susceptibility
disease MESH virus infection
pathway KEGG Influenza A
disease IDO secondary infection
disease MESH reinfection
disease MESH respiratory infections
disease MESH comorbidity
disease IDO history
disease MESH rhinitis
disease MESH sinusitis
disease MESH hospital acquired pneumonia
disease MESH inflammation
disease MESH frailty
disease MESH cardiovascular disease
disease MESH malformations
disease MESH chronic diseases
drug DRUGBANK Trestolone
drug DRUGBANK Etoperidone
disease MESH myocardial infarction
disease MESH stroke
disease MESH heart failure
disease MESH bacterial pneumonia
disease MESH viral load
disease MESH morbidity

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