Clinical risk factors are more relevant than respiratory viruses in predicting bronchiolitis severity1. Issue 5 (4th September 2012)

• Record Type: Journal Article
• Authors: Ricart, Silvia; Marcos, Maria Angeles; Sarda, Marta; Anton, Andres; Muñoz‐Almagro, Carmen; Pumarola, Tomas; Pons, Marti; Garcia‐Garcia, Juan Jose
• Is Part Of: Pediatric pulmonology. Volume 48:Issue 5(2013:May)
• Page Start: 456
• Page End: 463
• Publication Date: 2012-09-04
• Subjects: Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.22633
• Languages: English
• ISSNs: 8755-6863

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Background</title> <p>The role of respiratory viruses in the pathogenesis of bronchiolitis was re‐evaluated with the use of molecular methods such as PCR for virus detection. Whether specific viruses or the classical clinical risk factors are more important in determining severe bronchiolitis is not well established.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Aim</title> <p>To analyze the specific viruses and clinical variables that can predict severe bronchiolitis at admission.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Methods</title> <p>Nasopharyngeal aspirates were prospectively collected from 484 children <12 months admitted to the pediatrics ward or PICU at Universitary Hospital Sant Joan de Déu (Barcelona, Spain) for bronchiolitis from October 2007 to October 2008. Clinical and demographic data were collected. Sixteen respiratory viruses were studied using PCR. Severity was assessed with a bronchiolitis clinical score (BCS).</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Results</title> <p>Four hundred ten infants that tested positive for respiratory viruses were analyzed. Mixed viral infections did not increase the severity of the disease. Rhinovirus was associated with severe BCS in univariate analysis (<italic>P</italic> = 0.041), but in the multivariate logistic regression including viruses and clinical data only bronchopulmonary dysplasia (OR 7.2; 95% CI 1.2–43.3), congenital heart disease (OR 4.7; 95% CI 1.1–19.9), prematurity (OR 2.6; 95% CI 1.3–5.1), and fever (OR 1.8, 95% CI 1.1–3.1) showed statistical significance for predicting severe BCS.</p> </sec> <sec id="abs1-5" sec-type="section"> <title>Conclusions</title> <p>Classical clinical risk factors have more weight in predicting a severe BCS in infants with acute bronchiolitis than the involved viruses. Pediatr Pulmonol. 2013; 48:456–463. © 2012 Wiley Periodicals, Inc.</p> </sec> </abstract>