Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis
Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis
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DOI：
10.1007/s10096-011-1529-y
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发表时间：
2012-08-01
影响因子：
4.5
通讯作者：
Hervas, J. A.
中科院分区：
文献类型：
--
作者：
Hervas, D.;Reina, J.;Hervas, J. A.
我们研究呼吸道合胞病毒(RSV)阳性毛细支气管炎和阴性毛细支气管炎的临床、治疗和结果的差异。对1995年1月至2006年12月间2岁急性毛细支气管炎患儿的病历进行了回顾分析。有2384名患者因急性毛细支气管炎住院，其中1495名(62.7%)为呼吸道合胞病毒感染。总体而言，住院率为55/1000。死亡率为0.08%。呼吸道合胞病毒引起的毛细支气管炎在11月至3月更为常见(97%)。呼吸道合胞病毒毛细支气管炎的住院时间较长(6天比5天，P<；0.0001)，重症监护病房入院的风险更高(OR2.7；95%CI1.87~3.9)，氧气使用量更多(OR2.2；95%CI1.8~2.6)。婴儿和婴儿2个月的中位住院天数较长(6天比5天，P<；0.0001)和更高的ICU入院风险(OR 3.4；95%CI2.5-4.6)。早产32周、先天性心脏病和肺不张/冷凝是呼吸道合胞病毒毛细支气管炎和非呼吸道合胞病毒毛细支气管炎患者入院ICU的主要危险因素。Palivizumab在早产儿中的应用减少了RSV毛细支气管炎的住院时间、氧气需求、住院时间和机械通气。总之，这项研究支持呼吸道合胞病毒毛细支气管炎似乎是一种比其他病毒引起的更严重的疾病。
We study the clinical, management and outcome differences between respiratory syncytial virus (RSV) positive and negative bronchiolitis. A retrospective review of the medical records of children a parts per thousand currency sign 2 years of age with acute bronchiolitis between January 1995 and December 2006 was done. There were 2,384 patients hospitalized for acute bronchiolitis, and 1,495 (62.7%) were RSV infections. Overall, hospitalization rate was 55/1,000 admissions. Mortality occurred in 0.08% of cases. Bronchiolitis due to RSV was more frequent from November to March (97%). RSV bronchiolitis had longer hospital stays (6 vs. 5 days, P < 0.0001), higher risk of intensive care unit (ICU) admission (OR 2.7; 95%CI 1.87-3.9) and more oxygen use (OR 2.2; 95%CI 1.8-2.6). Infants < 2 months had longer median hospital stay (6 vs. 5 days, P < 0.0001) and higher risk of ICU admission (OR 3.4; 95%CI 2.5-4.6). Prematures of < 32 gestational weeks, congenital heart disease, and atelectasis/condensation were the main risk factors for ICU admission in both RSV and non-RSV bronchiolitis. The introduction of palivizumab in prematures diminished hospitalization for RSV bronchiolitis, oxygen need, length of hospital stay and mechanical ventilation. In conclusion, this study supports that RSV bronchiolitis seems to be a more severe disease than that caused by other viruses.