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American Academy of Pediatrics
Research Articles

Predictors of Hospitalization for Children With Croup, a Population-Based Cohort Study

Catherine M. Pound, Braden D. Knight, Richard Webster, Eric I. Benchimol and Dhenuka Radhakrishnan
Hospital Pediatrics December 2020, 10 (12) 1068-1077; DOI: https://doi.org/10.1542/hpeds.2020-001362
Catherine M. Pound
aChildren’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada;
bDivisions of Pediatrics,
cDepartment of Pediatrics and
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Braden D. Knight
dICES uOttawa, Ottawa, Canada;
eClinical Research Unit,
fOntario Child Health Support Unit, Ontario, Canada; and
gOttawa Hospital Research Institute, Ottawa, Canada;
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Richard Webster
eClinical Research Unit,
fOntario Child Health Support Unit, Ontario, Canada; and
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Eric I. Benchimol
aChildren’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada;
cDepartment of Pediatrics and
dICES uOttawa, Ottawa, Canada;
hGastroenterology, Hepatology and Nutrition, Children’s Hospital of Eastern Ontario, Ottawa, Canada;
iSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada;
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Dhenuka Radhakrishnan
aChildren’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada;
cDepartment of Pediatrics and
dICES uOttawa, Ottawa, Canada;
jRespirology, and
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Abstract

OBJECTIVES: We sought to determine predictors of hospitalization for children presenting with croup to emergency departments (EDs), as well as predictors of repeat ED presentation and of hospital readmissions within 18 months of index admission. We also aimed to develop a practical tool to predict hospitalization risk upon ED presentation.

METHODS: Multiple deterministically linked health administrative data sets from Ontario, Canada, were used to conduct this population-based cohort study between April 1, 2006 and March 31, 2017. Children born between April 1, 2006, and March 31, 2011, were eligible if they had 1 ED visit with a croup diagnosis. Multivariable logistic regression was used to determine factors associated with hospitalization, subsequent ED visits, and subsequent croup hospitalizations. A multivariable prediction tool and associated scoring system were created to predict hospitalization risk within 7 days of ED presentation.

RESULTS: Overall, 1811 (3.3%) of the 54 981 eligible children who presented to an Ontario ED were hospitalized. Significant hospitalization predictors included age, sex, Canadian Triage and Acuity Scale score, gestational age at birth, and newborn distress. Younger patients and boys were more likely to revisit the ED for croup. Our multivariable prediction tool could forecast hospitalization up to a 32% probability for a given patient.

CONCLUSIONS: This study is the first population-based study in which predictors of hospitalization for croup based on demographic and historical factors are identified. Our prediction tool emphasized the importance of symptom severity on ED presentation but will require refinement before clinical implementation.

  • Copyright © 2020 by the American Academy of Pediatrics
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Hospital Pediatrics: 10 (12)
Hospital Pediatrics
Vol. 10, Issue 12
1 Dec 2020
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Predictors of Hospitalization for Children With Croup, a Population-Based Cohort Study
Catherine M. Pound, Braden D. Knight, Richard Webster, Eric I. Benchimol, Dhenuka Radhakrishnan
Hospital Pediatrics Dec 2020, 10 (12) 1068-1077; DOI: 10.1542/hpeds.2020-001362

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Predictors of Hospitalization for Children With Croup, a Population-Based Cohort Study
Catherine M. Pound, Braden D. Knight, Richard Webster, Eric I. Benchimol, Dhenuka Radhakrishnan
Hospital Pediatrics Dec 2020, 10 (12) 1068-1077; DOI: 10.1542/hpeds.2020-001362
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