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Hospital Length-of-stay Is Associated With Rhinovirus Etiology of Bronchiolitis

Jartti, Tuomas MD*; Aakula, Matilda BM*; Mansbach, Jonathan M. MD, MPH; Piedra, Pedro A. MD; Bergroth, Eija MD§; Koponen, Petri MD; Kivistö, Juho E. MD¶**; Sullivan, Ashley F. MS, MPH; Espinola, Janice A. MPH; Remes, Sami MD§; Korppi, Matti MD; Camargo, Carlos A. Jr. MD, DrPH

The Pediatric Infectious Disease Journal: August 2014 - Volume 33 - Issue 8 - p 829–834
doi: 10.1097/INF.0000000000000313
Original Studies

Objective: To determine whether hospital length-of-stay (LOS) for bronchiolitis is influenced by the causative virus: respiratory syncytial virus (RSV) or rhinovirus.

Methods: This prospective study was carried out in 3 university hospitals in Finland during 2 consecutive winter seasons. We enrolled consecutive children <2 years of age hospitalized with an attending physician’s diagnosis of bronchiolitis. All enrolled children were included in the primary analysis. A parallel analysis was also conducted using a stricter definition for bronchiolitis (age <12 months and no history of wheeze). Polymerase chain reaction was used to test the nasopharyngeal aspirate samples for multiple respiratory pathogens.

Results: The median age of the 408 children was 8 months, 73% had no history of wheeze and their median hospital LOS was 2 days. 144 (35%) children had RSV only and 92 (23%) children rhinovirus only infections. Children with rhinovirus only had shorter duration of prehospital symptoms, higher disease severity score at entry and more often a history of wheezing (all P ≤ 0.001). Controlling for 7 demographic and clinical characteristics, those with rhinovirus only had shorter hospital LOS when compared with children with RSV only (adjusted odds ratio: 0.45; 95% confidence interval: 0.22–0.92; P = 0.03). The rhinovirus only finding was similar in the subset of 206 children with stricter diagnosis (adjusted odds ratio: 0.30; 0.06–1.49; P = 0.14).

Conclusions: Hospital LOS is associated with rhinovirus etiology of bronchiolitis. Our data call attention to the importance of both RSV and rhinovirus testing in clinical research.

Supplemental Digital Content is available in the text.

From the *Department of Pediatrics, Turku University Hospital, Turku, Finland; Department of Medicine, Boston Children’s Hospital, Boston, MA; Departments of Molecular Virology and Microbiology, and Pediatrics, Baylor College of Medicine, Houston, TX; §Department of Pediatrics, Kuopio University Hospital, Kuopio; Department of Pediatrics, Tampere University Hospital, Tampere, Finland; and Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; **Allergy Unit, Tampere University Hospital, Tampere, Finland

Accepted date for publication February 11, 2014.

T.J. was supported by the Academy of Finland (grant numbers 132595 and 114034) and the Finnish Medical Foundation, both in Helsinki, Finland; M.A. was supported by the Foundation for Pediatric Research, Helsinki, Finland and E.B. was supported by the Kerttu and Kalle Viikki Foundation and specific government transfers (EVO) funding, both in Kuopio, Finland. J.E.K. was supported by the Competitive Research Funding of Pirkanmaa District Hospital.

The authors have no other funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (

Address for correspondence: Tuomas Jartti, MD, The Department of Pediatrics, Turku University Hospital, P.O. Box 52, FIN-20520 Turku, Finland. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.