Demographic and Clinical Determinants of Acute Bronchiolitis Outcomes in a Tertiary Pediatric Hospital in Dubai, United Arab Emirates.

backgroundBronchiolitis is a lower respiratory tract infection that affects children under two years of age and is considered a cause of increased morbidity and healthcare costs, especially during the winter season. Despite its global burden, evidence on how local demographic or clinical factors influence outcomes in Middle Eastern populations remains limited.

objectivesThis study aims to examine the descriptive epidemiology and different demographic and clinical characteristics of patients admitted with bronchiolitis, and to evaluate exploratory associations between these characteristics and various clinical outcomes, including duration of hospital admission, need for pediatric intensive care unit (PICU) admission, and need for invasive oxygen supplementation.

methodsThis retrospective study included all infants aged 1-24 months who were admitted with bronchiolitis between October 1, 2022, and March 31, 2023. Electronic records from Cerner and Salama (Epic) were screened. Variables extracted included age at presentation, sex, nationality, gestational age, feeding type, family history of atopy, viral PCR results, initial oxygen saturation, and therapies received. Primary outcomes were PICU admission, maximum oxygen support, and length of stay. Associations were assessed using chi‑square or Fisher's exact tests for categorical variables and Mann-Whitney U tests for continuous variables, with significance set at p < 0.05.

resultsOf 1,804 screened encounters, 232 patients were eligible for the study. The mean (± SD) age was 6.6 ± 5.2 months, and 138 patients (59.5%) were male. Respiratory syncytial virus (RSV) was detected in 101 patients (43.5%), rhinovirus/enterovirus in 29 patients (12.5%), and mixed/other viruses in 53 patients (22.8%). A high-flow nasal cannula was used in 87 cases (37.5%), but only 14 patients (6.1%) required PICU admission. None of the demographic or clinical factors showed a statistically significant effect on the chance of PICU admission or oxygen requirement. A family history of atopy was the only factor associated with a shorter length of stay (Mann-Whitney U = 2503.5; p = 0.008). Steroid therapy was more frequently administered to infants requiring greater oxygen support (chi-square = 13.971; p < 0.001), but did not shorten hospital stays or reduce PICU admissions.

conclusionsIn this cohort from the United Arab Emirates, bronchiolitis outcomes were largely independent of demographic factors, viral etiology, or corticosteroid use. Adherence to international guidelines, which advocate for supportive care and discourage the routine use of glucocorticoids or bronchodilators, is likely to improve resource utilization without compromising outcomes.