Ramos-Fernández José Miguel, Piñero-Domínguez Pedro, Abollo-López Pilar, Moreno-Pérez David, Cordón-Martínez Ana María, Milano-Manso Guillermo, Urda-Cardona Antonio
Unidad de Gestión Clínica de Pediatría, Grupo de Investigación IBIMA, Hospital Materno-Infantil Regional Universitario de Málaga, Málaga, España.
Unidad de Gestión Clínica de Pediatría, Grupo de Investigación IBIMA, Hospital Materno-Infantil Regional Universitario de Málaga, Málaga, España.
An Pediatr (Engl Ed). 2018 Aug;89(2):104-110. doi: 10.1016/j.anpedi.2017.09.006. Epub 2017 Nov 11.
At present, there are few validated scoring tests for assessing acute bronchiolitis (AB) severity, and limited information on their test power. The aim of the present study is to evaluate the validity of an acute bronchiolitis severity score (ABSS) to help in deciding PICU admission.
Prospective, descriptive, observational study of previously healthy infants under 1 year of age with AB, where the ABSS was used to compare severity as regards the need for PICU admission. The sample size was estimated as at least 175 patients. The research team was trained in the use of ABSS. All patients in the study were evaluated with ABSS daily, as well as in the case of clinical deterioration. The initial and maximum ABSS scores were contrasted to the need for PICU admission. A receiver operative curve was constructed, and the area under the curve was calculated, and the optimum point of sensitivity / specificity was estimated.
The study included a total of 190 patients (male / female: 58% / 42%). PICU was required in 11 (6%). The mean± SD ABSS-maximal score for patients who required and did not require PICU was 10.55± 1.12 and 6.35± 2.3, respectively (P<.001). The AUC for ABSS-maximal was 0.94 (P<.001, 95% CI: 0.90-0.98). The optimal cut-off point was set at ≥10 points for a sensitivity of 82% and a specificity of 91%.
ABSS estimates the severity of AB regarding the need for PICU admission, with a sensitivity and specificity of clinical usefulness.
目前，用于评估急性细支气管炎（AB）严重程度的有效评分测试较少，且关于其测试效能的信息有限。本研究的目的是评估急性细支气管炎严重程度评分（ABSS）在帮助决定儿科重症监护病房（PICU）收治方面的有效性。
对1岁以下患有AB的既往健康婴儿进行前瞻性、描述性、观察性研究，使用ABSS比较PICU收治需求方面的严重程度。样本量估计至少为175例患者。研究团队接受了ABSS使用培训。研究中的所有患者每天以及临床病情恶化时均使用ABSS进行评估。将初始和最高ABSS评分与PICU收治需求进行对比。构建受试者工作曲线，计算曲线下面积，并估计最佳敏感度/特异度点。
该研究共纳入190例患者（男/女：58%/42%）。11例（6%）需要入住PICU。需要和不需要入住PICU的患者的平均±标准差ABSS最高评分为10.55±1.12和6.35±2.3，分别（P<0.001）。ABSS最高评分的AUC为0.94（P<0.001，95%CI：0.90 - 0.98）。最佳截断点设定为≥10分，敏感度为82%，特异度为91%。
ABSS可评估AB在PICU收治需求方面的严重程度，具有临床实用的敏感度和特异度。
