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Hospital admission trends for bronchiolitis in Scotland, 2001-2016: a national retrospective observational study

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Original languageEnglish
JournalThe Journal of Infectious Diseases
Early online date14 Aug 2020
DOIs
Publication statusE-pub ahead of print - 14 Aug 2020

Abstract

Bronchiolitis is the commonest cause of respiratory related hospital admissions in young children. This study aimed to describe temporal trends in bronchiolitis admissions for children under 2 years of age in Scotland by patient characteristics, socioeconomic deprivation and duration of admission. The national hospital admissions database for Scotland (SMR01) was used to extract data on all bronchiolitis admissions (ICD-10 code J21) in children under 2 years of age from 2001 to 2016. Deprivation quintiles was classified using the 2011 Scottish Index of Multiple Deprivation (SIMD). Over the 15-year study period, admission rates for children under 2 years old increased 2.20-fold (95% CI 1.4-3.6) from 17.2 (95% CI 15.9-18.5) to 37.7 (95% CI 37.4-38.1) admission per 1,000 children per year. Admissions peaked in infants aged 1 month, and in those born in the three months preceding the peak bronchiolitis month – September, October, and November. Admissions from the most deprived quintile had the highest overall rate of admission at 40.5 per 1,000 children per year (95% CI 39.5-41.5) compared with the least deprived quintile at 23.0 admissions per 1,000 children per year (95% CI 22.1-23.9). The most deprived quintile had the greatest increase in admissions over time, whilst the least deprived quintile had the lowest increase in admissions over time. Zero-day admissions, defined as admission and discharge within the same calendar date, increased 5.3-fold (95% CI 5.1-5.5) over the study period, with the highest increase in patients in the most deprived quintile. This study provides baseline epidemiological data to aid policy makers in the strategic planning of preventative interventions. With the majority of bronchiolitis caused by Respiratory Syncytial Virus (RSV), and several RSV vaccines and monoclonal antibodies currently in clinical trials, understanding national trends in bronchiolitis admissions is an important proxy for determining potential RSV vaccination strategies.

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