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Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727

Abstract

RAMOS-FERNANDEZ, José Miguel et al. Prediction of Severe Course in Infants with RSV Bronchiolitis under 6 Months. Spain. Rev. Esp. Salud Publica [online]. 2017, vol.91, 201701006.  Epub Jan 19, 2017. ISSN 2173-9110.

Background.

The need for mechanical ventilation (MV) in acute bronchiolitis (AB) by respiratory syncytial virus (RSV) varies depending on the series (6-18%). Our goal is to determine the admissions to PICU for MV in patients under 6 months with AB and define the risk factors for building a prediction model.

Methods.

Retrospective study of patients younger than 6 months admitted by BA-VRS between the periods April 1, 2010 and March 31, 2015 was made. The primary variable was the admission to PICU for MV. Related addition, to find risk factors in a model of binary logistic regression clinical variables were collected. A ROC curve model was developed and optimal cutoff point was identified.

Results.

In 695 cases, the need of MV in the PICU was 56 (8.1%). Risk factors included in the equation were: 1. male sex (OR 4.27) 2. postmenstrual age (OR: 0.76) 3. Weight income <p3 (OR: 5.53) 4. intake <50% (OR: 12.4) 5. Severity by scale (OR: 1.58) 6. apneas before admission (OR: 25.5) 7. bacterial superinfection (OR 5.03) and 8. gestational age> 37 weeks OR (0.32). The area under the curve, sensitivity and specificity were 0.943, 0.84 and 0.93 respectively.

Conclusions.

The PICU admission for MV was 8.1 in every 100 healthy infants hospitalized for AB and year. The prediction model equation can help to predict patients at increased risk of severe evolution.

Keywords : Incidence; Bronchiolitis; Intensive Care Units; Pediatric; Mechanical ventilation; Logistic model; Respiratory Syncytial Viruses.

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