Prospective evaluation of clinical scoring systems in infants with bronchiolitis admitted to the intensive care unit

• Published in: European journal of clinical microbiology & infectious diseases 2012-10, Vol.31 (10), p.2667-2672
• Main Authors: Rödl, S., Resch, B., Hofer, N., Marschitz, I., Madler, G., Eber, E., Zobel, G.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Birth Weight; Bronchiolitis - pathology; Bronchiolitis - virology; Bronchopulmonary Dysplasia - diagnosis; Bronchopulmonary Dysplasia - virology; Chronic illnesses; Chronic obstructive pulmonary disease, asthma; Epidemiology; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Premature; Infants; Infectious diseases; Intensive care; Intensive Care Units, Pediatric - standards; Internal Medicine; Lung diseases; Medical Microbiology; Medical sciences; Mortality; Mortality risk; Neonatal care; Neuromuscular diseases; Patients; Pediatrics; Pneumology; Prospective Studies; Respiration, Artificial; Respiratory syncytial virus; Respiratory Syncytial Virus Infections - diagnosis; Respiratory Syncytial Virus Infections - virology; Respiratory Syncytial Viruses - pathogenicity; ROC Curve; Sensitivity and Specificity; Severity of Illness Index; Software; Time Factors; Ventilation; Ventilators
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-012-1612-z

The objective of this investigation was to compare different scoring systems to assess the severity of illness in infants with bronchiolitis admitted to a tertiary paediatric intensive care unit (PICU). Over an 18-year period (1990–2007), infants with bronchiolitis aged up to 12 months and admitted to the PICU were prospectively scored using the Pediatric Risk of Mortality III (PRISM III) score, the Organ System Failure (OSF) score and the Acute Physiologic Score for Children (APSC) within 24 h. Infants were compared as to whether or not bronchiolitis was associated with respiratory syncytial virus (RSV). There was no difference between 113 RSV-positive and 80 RSV-negative infants regarding gestational age, birth weight, rate of premature delivery or bronchopulmonary dysplasia (BPD). The PRISM III score differed significantly between RSV-positive and RSV-negative cases (3.27 ± 0.39 vs. 1.96 ± 0.44, p  = 0.006), as did the OSF score (0.56 ± 0.05 vs. 0.35 ± 0.06, p  = 0.049) and the APSC (5.16 ± 0.46 vs. 4.1 ± 0.53, p  = 0.048). All scores were significantly higher in the subgroup with mechanical ventilation ( p