A predictive model of inappropriate use of medical tests and medications in Bronchiolitis

ABSTRACT: Few studies have identified predictors of inappropriate use of medications and medical tests in bronchiolitis. This study aimed to look for potential factors associated with the inappropriate use of medications and tests in bronchiolitis. A retrospective study that included all infants under two years of age in tertiary center admitted due to Bronchiolitis from January 2015 to December 2018. We defined a composite score as the main outcome variable. 1930 patients were included. The most prescribed medications were nebulized hypertonic saline in 1789 patients (92.6%), albuterol (56%), and β-lactam antibiotics (26.4%). The medical tests more commonly ordered were hemogram (95.9%), chest X-rays (92.2%) and C-reactive protein (79.8%). After controlling for potential confounders, it was found that the length of hospital stay increases the risk of the inappropriate use of medications and tests (OR 1.29; CI 95% 1.01-1.65), whereas fever (OR 0.22; CI 95% 0.06-0.71) and leukocytosis (> 15,000/μL) (OR 0.09; CI 95% 0.03-0.32) at admission decrease the risk of the inappropriate use of medications and tests. Inappropriate use of diagnostic tests and drugs for bronchiolitis was a highly prevalent outcome in our population. Patients with longer hospitalizations, absence of fever and a normal white blood cell count at admission, were at increased risk of inappropriate use of medications and medical tests.

• Autores: Buendía Rodríguez, Jefferson Antonio; Rodríguez Jaramillo, Carlos Andrés
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2020
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/44828
• Acceso en línea: https://hdl.handle.net/10495/44828
• Palabra clave: Bronquiolitis; Bronchiolitis; Preescolar; Child, Preschool; Hospitalization; Tiempo de Internación - estadística & datos numéricos; Length of Stay - statistics & numerical data; Pautas de la Práctica en Medicina; Practice Patterns, Physicians; Procedimientos Innecesarios - estadística & datos numéricos; Unnecessary Procedures - estadística & datos numéricos; https://id.nlm.nih.gov/mesh/D001988; https://id.nlm.nih.gov/mesh/D002675; https://id.nlm.nih.gov/mesh/D006760; https://id.nlm.nih.gov/mesh/D007902; https://id.nlm.nih.gov/mesh/D010818; https://id.nlm.nih.gov/mesh/D019564
• Rights: openAccess
• License: http://creativecommons.org/licenses/by/2.5/co/