Mecklin Minna, Heikkilä Paula, Korppi Matti
Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
Acta Paediatr. 2017 Dec;106(12):2004-2010. doi: 10.1111/apa.14021. Epub 2017 Sep 27.
This study evaluated the incidence and risk factors for intensive care and respiratory support in infant bronchiolitis.
This retrospective descriptive case-control study focused on 105 patients treated in the paediatric intensive care unit (PICU) and 210 controls treated in the emergency department or on the paediatric ward in Tampere University Hospital in Finland between 2000 and 2015. Statistically significant risk factors in nonadjusted analyses were included in the adjusted logistic regression.
The average age-specific annual incidence of bronchiolitis requiring PICU admission under the age of 12 months was 1.5/1000/year (range 0.18-2.59). Independently, significant risk factors for PICU admission were as follows: being less than two months old with an adjusted odds ratio (aOR) of 11.5, birthweight of <2000 g (aOR of 15.9), congenital heart disease (CHD) (aOR of 15.9), apnoea (aOR of 7.2) and the absence of wheezing (aOR of 2.2). Significant risk factors for needing respiratory support were a birthweight of <2000 g, an age of less than two months and CHD.
Less than 0.1% of infants under the age of 12 months were admitted to the PICU for bronchiolitis. Low age, low birthweight or prematurity and CHD were independently significant risk factors for both intensive care and respiratory support.
本研究评估了婴儿细支气管炎患者重症监护及呼吸支持的发生率和危险因素。
这项回顾性描述性病例对照研究聚焦于2000年至2015年期间在芬兰坦佩雷大学医院儿科重症监护病房(PICU)接受治疗的105例患者以及在急诊科或儿科病房接受治疗的210例对照。未校正分析中有统计学意义的危险因素被纳入校正逻辑回归分析。
12个月以下需要入住PICU的细支气管炎患者按年龄计算的年均发病率为1.5/1000/年(范围为0.18 - 2.59)。独立来看,入住PICU的显著危险因素如下:年龄小于2个月,校正比值比(aOR)为11.5;出生体重<2000 g(aOR为15.9);先天性心脏病(CHD)(aOR为15.9);呼吸暂停(aOR为7.2)以及无喘息(aOR为2.2)。需要呼吸支持的显著危险因素为出生体重<2000 g、年龄小于2个月以及CHD。
12个月以下的婴儿因细支气管炎入住PICU的比例不到0.1%。低年龄、低出生体重或早产以及CHD是重症监护和呼吸支持的独立显著危险因素。