Allergy Asthma Respir Dis.  2013 Dec;1(4):377-382. 10.4168/aard.2013.1.4.377.

Association between the clinical index and disease severity in infants with acute bronchiolitis

• Kim KH
• Hwang J
• Song JH
• Lee YS
• Kwon JW
• Suh DI
• Park JD
• Koh YY

• KMID: 2262597
• DOI: http://doi.org/10.4168/aard.2013.1.4.377

Abstract

PURPOSE
We aimed to verify whether the formal clinical index derived from infants and toddlers have a good association with the disease severity when we confine subjects to only infants, who undergo profound changes physically and immunologically.
METHODS
We retrospectively reviewed the medical records of hospitalized infants with acute bronchiolitis caused by respiratory syncytial virus between January 1, 2010 and December 31, 2011 in three hospitals. The age, respiratory rate, presentation of chest retraction, and percutaneous oxygen saturation upon admission; presentation of fever, use of oxygen therapy and inhaled corticosteroid within 24 hours after admission were investigated. We then examined the effect of clinical index on severity of acute bronchiolitis; the mean length of stay, mean duration of fever and oxygen therapy.
RESULTS
A total of 172 infants were studied. The mean length of stay was longer in patients younger than 3 months (P=0.015), in those with fever (P=0.028) and chest retraction (P=0.014), and in those who needed oxygen supplement (P=0.000). In the patients with fever, the mean duration of fever was longer in those who needed the oxygen supplement than those who did not (P=0.046).
CONCLUSION
Younger than 3 months of age, chest retraction upon admission; fever, need of oxygen supplement within 24 hours after admission may predict the severe course of infants with acute bronchiolitis.

Keyword

Acute bronchiolitis; Clinical index; Infant; Respiratory syncytial virus

MeSH Terms

Bronchiolitis*
Fever
Humans
Infant*
Length of Stay
Medical Records
Oxygen
Respiratory Rate
Respiratory Syncytial Viruses
Retrospective Studies
Thorax
Oxygen

Figure

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  Fig. 1 The age (A), chest retraction (B), fever (C), and oxygen supplement (D) were associated with the length of stay. All boxplots: median; 10th, 25th, 75th, 90th percentiles.

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  Fig. 2 The mean length of stay was shorter than in those who did not require saturation monitoring than those who needed saturation monitoring. There was no difference between the group of more than oxygen saturation 90% and the group of less than oxygen saturation 90%. All boxplots: median; 10th, 25th, 75th, 90th percentiles. *Student t-test. †Mann-Whitney U test.

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  Fig. 3 In the patients with fever, the oxygen supplement was associated with the duration of fever. All boxplots: median; 10th, 25th, 75th, 90th percentiles.

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