Severity of illness models for respiratory syncytial virus-associated hospitalization

The objective of this investigation was to examine the feasibility of multi variate severity of illness models for pediatric patients hospitalized with respiratory syncytial virus (RSV) infection, From a preexisting retrospect ive cohort study database, all infants and children 2 yr of age or younger with community-acquired RSV infection admitted to the University of Michiga n's C. S. Mott Children's Hospital during nine epidemics were examined, The study group consisted of 802 hospitalized patients younger than 2 yr of ag e with community-acquired RSV infection; 182 (23%) patients had prolonged h ospital length of stay defined as 7 d or greater. Multivariate logistic reg ression modeling of nine variables measurable during the first hospital day was strongly associated with prolonged hospitalization (p < 0.0001), Recei ver operator characteristic curve analysis resulted in an area under the cu rve of 0.894, indicating excellent model discrimination, Goodness-of-fit te sting indicated excellent model calibration for observed versus predicted o utcomes (p = 0.216). We conclude that severity of illness models for RSV-as sociated hospitalization with excellent predictive properties in terms of c lassification, discrimination, and calibration are possible. Further study is required to determine if such models are generalizable across multiple c enters and epidemics.