Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Respir Med. 2020 Jan;161:105824. doi: 10.1016/j.rmed.2019.105824. Epub 2019 Nov 16.
Despite advances in medical knowledge, the treatment of viral bronchiolitis is mainly supportive. Antiviral therapies are being investigated in clinical trials. Identifying population-attributable risk factors for RSV hospitalization may help prioritizing targeted treatment.
To utilize MDClone, a data acquisition tool, to examine factors associated with the risk of hospitalization and length of stay (LOS) in bronchiolitis.
A single tertiary medical center retrospective study. Infants discharged with a diagnosis of bronchiolitis between January 2001 and March 2019 were included. Demographic, clinical, laboratory, microbiologic parameters and co-morbidities were collected. Correlations with the risk of hospitalization and LOS were examined.
A total of 4793 infants with bronchiolitis, 3851 (80.3%) previously healthy, were seen; 975 visited emergency room only; 3311 were hospitalized in pediatric wards and 507 required pediatric intensive care unit. O saturation, age and fever correlated with the risk of hospitalization (OR = 0.703, p < 0.0001, OR = 0.4, p = 0.024 and OR = 2.388, p < 0.0001, respectively). Saturation, fever, gestational age and birth weight correlated with LOS (r = -0.283, p = 0.000; r = 0.16, p = 0.000; r = -0.12, p = 0.00; and r = -0.117, p = 0.00, respectively). Rates of hospitalization were higher (81.1% vs. 75.6%, p = 0.0008) and LOS was longer (median 2.97 vs. 2.73 days, p < 0.001) in Arabs than in Jews. In a multivariate model, saturation, fever, gestational age and age predicted LOS. Saturation and ethnicity predicted LOS for previously healthy infants. Prematurity and cardiac anomalies increased LOS (p = 0.016 and p < 0.0001, respectively).
Population-based data may enable predicting disease severity and LOS in bronchiolitis. Focusing on children at greatest risk may aid targeting new therapies.
尽管医学知识取得了进步，但病毒性细支气管炎的治疗主要还是支持性的。抗病毒疗法正在临床试验中进行研究。确定 RSV 住院的人群归因风险因素可能有助于确定靶向治疗的优先级。
利用 MDClone 数据采集工具，研究与毛细支气管炎住院风险和住院时间（LOS）相关的因素。
这是一项单中心回顾性研究。纳入 2001 年 1 月至 2019 年 3 月期间以毛细支气管炎出院的婴儿。收集人口统计学、临床、实验室、微生物学参数和合并症。研究与住院风险和 LOS 的相关性。
共纳入 4793 例毛细支气管炎患儿，其中 3851 例（80.3%）既往健康，975 例仅在急诊就诊，3311 例在儿科病房住院，507 例需要儿科重症监护病房。氧饱和度、年龄和发热与住院风险相关（OR=0.703，p<0.0001，OR=0.4，p=0.024，OR=2.388，p<0.0001）。饱和度、发热、胎龄和出生体重与 LOS 相关（r=-0.283，p=0.000；r=0.16，p=0.000；r=-0.12，p=0.00；r=-0.117，p=0.00）。阿拉伯裔儿童的住院率更高（81.1%比 75.6%，p=0.0008）， LOS 更长（中位数 2.97 比 2.73 天，p<0.001）。在多变量模型中，饱和度、发热、胎龄和年龄预测 LOS。饱和度和种族预测既往健康儿童的 LOS。早产儿和心脏异常增加 LOS（p=0.016 和 p<0.0001）。
基于人群的数据可能有助于预测细支气管炎的严重程度和 LOS。关注风险最高的儿童可能有助于靶向新疗法。
