SHM Converge Scientific Abstract ePoster Gallery-Evaluation of Repeat Decadron Dosing in Children Admitted With Croup

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This retrospective study evaluated whether repeat dexamethasone (DEX) dosing improves outcomes in children hospitalized with uncomplicated viral croup. The authors reviewed 506 croup admissions among 485 children ages 6 months to 7 years at Children’s Wisconsin from 2013–2021. They examined inpatient repeat DEX use and “for the road” doses given at discharge, focusing on length of stay (LOS), 30-day readmission, symptom recurrence, and ICU transfer.<br /><br />Most children were male (71%), with a median age of 17 months. Repeat inpatient DEX was common: 18% received at least two doses, and 35.5% received a dose at discharge. Despite this variation, neither the total number of DEX doses given in the hospital nor discharge dosing was associated with lower readmission or recurrence rates. Readmission was low overall (3.8%), and outpatient recurrence occurred in 7.9% of cases. There was also no evidence that the number of racemic epinephrine treatments predicted discharge DEX use.<br /><br />However, after adjusting for clinical and demographic factors, including the Bedside Pediatric Early Warning Score (BPEWS), more DEX doses were associated with a longer hospital stay. The authors note this may partly reflect greater illness severity, though repeat dosing itself did not appear to improve outcomes.<br /><br />The study also found that 39% of children had at least one x-ray, suggesting frequent imaging despite low yield.<br /><br />Overall, the findings suggest that additional dexamethasone doses for croup do not reduce readmission or recurrence and may be linked to longer hospitalization. The authors recommend more research into repeat DEX use and imaging practices to reduce unnecessary interventions.

Asset Subtitle

Sheila Swartz

Meta Tag

Author List Brandon Palmer, Gabriel Aguero, Jennifer Hadjiev, Jian Zhang, Ke Yan, Leah Cotter, Sheila Swartz

Category Research

Concept Dexamethasone

Concept Croup

Concept Repeat dosing

Concept Readmission

Concept Recurrent Symptoms

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Sheila Swartz

Track Pediatric

Keywords

croup

dexamethasone

repeat dosing

pediatric hospitalization

viral croup

length of stay

readmission

symptom recurrence

racemic epinephrine

children's hospital

Dexamethasone

Croup

Repeat dosing

Readmission

Recurrent Symptoms