Criteria for Safe Hospital Discharge in Bronchiolitis: A Systematic Review.

TL;DR

Systematic review of discharge criteria for hospitalized infants with bronchiolitis found low-certainty evidence that structured discharge criteria reduce length of stay without increasing readmission rates. Updated 2025 Australasian guidelines now incorporate prescriptive discharge criteria addressing clinical stability, oxygenation, feeding, caregiver factors, and follow-up arrangements.

Key findings

• Only two retrospective observational studies (N=2697) met inclusion criteria, both showing reduced length of stay with structured discharge protocols versus alternatives
• No significant difference in readmission rates between structured discharge criteria and alternative protocols across included studies
• Evidence certainty rated low-to-very-low due to study design limitations, indirectness, and imprecision
• Updated discharge criteria address: clinical stability, oxygen saturation/support requirements, feeding ability, caregiver confidence/education, social factors, and follow-up planning

Why this matters at the bedside

Provides practical, consensus-based discharge criteria for bronchiolitis to standardize decision-making and potentially reduce unnecessary hospitalization, though physicians should recognize the limited evidence base supporting these recommendations.