G505(P) Bronchiolitis: a comparative analysis of high dependency unit (hdu) admissions and ward admissions

Background Our tertiary paediatric centre has approximately 8300 admissions a year. Bronchiolitis is a common illness requiring admission but only 10% require high dependency care (HDU). Is there a difference between those patients requiring HDU and those who do not? Aims To complete a retrospective comparative case analysis comparing demographics and features of illness between the two groups to determine any relationships to HDU admission. Methods All bronchiolitis admissions (n=509) from September 2016 to April 2017 were identified in patients up to 14 months of age. There were 53 admissions to HDU. Forty nine had complete electronic clinical records available to review. Fifty admissions receiving ward level care were randomly selected for comparison. Statistical analysis was completed using descriptive statistics, the Independent T test and Pearson’s Chi Squared. Results Table one shows the comorbidities. A significantly greater number of patients with a cardiac abnormality required admission to HDU. Admission to hospital earlier (days of coryza), higher respiratory rate and the need for oxygen were statistically significantly related to HDU admission. There was no viral aetiology that related to HDU admission when compared with the ward cohort. Conclusion The only comorbidity identified that was related to HDU admission was a cardiac abnormality. There was no statistical relationship with prematurity, chronic lung disease, home oxygen or neuromuscular conditions identified. Earlier admission in illness, higher respiratory rate and oxygen requirement could all be used as surrogate markers for disease severity and were more prominent in the HDU group.