The Impact of a History of Pre-maturity on Viral Respiratory Infections in Children Under 2 Years of Age: A Propensity Score-Matching Analysis of in-hospital Complications and Mortality

Introduction: A history of prematurity may be a risk factor for complications in patients hospitalized for viral respiratory infections (VRIs). Objective: To identify the impact of a history of prematurity on in-hospital complications and mortality in patients under 24 months of age hospitalized for VRIs over a period of 5 years. Material and methods: This was a propensity score‐matched study. The database was compiled by doctors, electronically validated by engineers and analyzed by statisticians. Patients with VRI (based on International Classification of Diseases [ICD-10]) codes B974, J12, J120-J129X, J168, J17, J171, J178, J20, J203-J209, J21, J210, J211, J218, J219, J22X, and J189) from 2013 to 2017 were enrolled in the study. Patients were classified into 2 groups according to the absence or presence of a history of prematurity (P070, P072, P073). Patients with congenital heart disease (CHD) (Q20-Q26) were excluded. The length of hospital stay, in-hospital complications, surgical procedures and mortality were analyzed. Statistical analysis: Patients were matched according to age. For comparisons between groups, Student's t-tests and chi2 tests were applied. A logistic regression model was constructed to identify factors related to in-hospital complications and mortality. Results: In total, 5,880 patients were eligible for inclusion in the analysis. The average patient age was 14.25 weeks. The presence of prematurity (coefficient = 1.16), male sex, (BPD), in-hospital infectious complications (coefficient = 11.31) and invasive medical procedures (coefficient = 18.4) increased the number of days of hospitalization. Invasive medical procedures (OR = 6.13), a history of prematurity (OR = 2.54) and male sex (OR = 1.78) increased the risk for in-hospital complications. In-hospital infectious complications (OR = 84.2) and invasive medical procedures (OR = 58.4) were risk factors for mortality. Conclusions: A history of prematurity increased the length of hospital stay and the rate of in-hospital complications but did not increase mortality in patients under 24 months of age hospitalized for VRIs.