Temporal Trends of Respiratory Syncytial Virus-Associated Hospital and ICU Admissions Across the United States

Objectives: To describe the regionality and seasonality of respiratory syncytial virus-associated hospital and ICU admissions for 10 consecutive years using a national database.

Design: Post hoc analysis of data from an existing national database, Pediatric Health Information System. We modeled the adjusted odds of hospital and ICU admissions for varied seasons (fall, winter, spring, and summer) and regions (Northeast, South, Midwest, and West) using a mixed-effects logistic regression model after adjusting for several patient and center characteristics.

Setting: Forty-two children's hospitals across the Unites States.

Patients: Patients 1 day through 24 months old with inpatient admission (ward and/or ICU) for respiratory syncytial virus- associated infection at a Pediatric Health Information System-participating hospital were included (2004-2013).

Interventions: None.

Measurements And Main Results: Of 1,937,994 inpatient admissions during the study period, 146,357 children were admitted for respiratory syncytial virus-associated acute respiratory illness. Of these inpatient admissions, 32,470 children(22%) were admitted to ICU during their hospital stay. Overall adjusted odds of respiratory syncytial virus-associated hospital and ICU admissions in recent years (2010-2013) were higher than previous years (2004-2006 and 2007-2009). In recent years, respiratory syncytial virus-associated hospital and ICU admissions have increased in winter and spring seasons. Regionally in recent years, the overall adjusted odds of both respiratory syncytial virus-associated hospital and ICU admissions have increased in the South and West regions.

Conclusions: Wide variations in regional and seasonal patterns in hospital and ICU admissions were noted in children with respiratory syncytial virus-associated acute respiratory illness across the United States. Results from our study help us better understand the seasonality and regionality of respiratory syncytial virus infection in the United States with the goal to decrease the financial impact on our already stressed healthcare system by being better prepared for respiratory syncytial virus season.