Bronchiolitis hospitalizations in rural New England: clues to disease prevention.

Bronchiolitis hospitalizations in rural New England: clues to disease prevention.
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DOI:
10.1177/20499361221099447
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发表时间:
2022-01
影响因子:
5.7
通讯作者:
Brickley, Elizabeth B.
Brickley, Elizabeth B.
中科院分区:
其他
文献类型:
--
作者:
Wright, Peter F.;Hoen, Anne G.;Jarvis, J. Dean;Zens, Michael S.;Dade, Erika F.;Karagas, Margaret R.;Taube, Juliana;Brickley, Elizabeth B.

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毛细支气管炎住院的临床流行病学,呼吸道合胞病毒(RSV)疾病的临床替代品,提高认识,是至关重要的,为减轻在生命早期的毛细支气管炎住院病人的负担告知公共卫生策略。对2010年11月1日至2017年10月31日期间在达特茅斯-希区柯克儿童医院(CHaD)首次入院的所有毛细支气管炎患者(N = 295)进行了回顾性病历审查,使用了该疾病的相关国际疾病分类(ICD)-9和ICD-10代码。提取的数据包括RSV感染的实验室确认、疾病严重程度、住院持续时间、入院时年龄(天)、入院时体重、早产、兄弟姐妹和相关的医学既存疾病。因细支气管炎入院与患儿的年龄、出生月份以及家中是否有较大的孩子密切相关。与入院相关的医学风险因素包括早产和基础心肺疾病。非常早的住院年龄强调了RSV在社区中的高渗透率,这意味着母体抗体提供的保护有限,以及保护婴儿免受这种感染的复杂性。虽然呼吸道合胞病毒(RSV)/细支气管炎住院治疗的风险得到了很好的描述,但很少有研究精确地检查RSV/细支气管炎的年龄相关频率和严重程度。我们还探讨了RSV的临床流行病学的影响,为我们了解疾病的发病机制和最佳的预防方法的发展。
An improved understanding of the clinico-epidemiology of bronchiolitis hospitalizations, a clinical surrogate of respiratory syncytial virus (RSV) disease, is critical to inform public health strategies for mitigating the in-patient burden of bronchiolitis in early life. A retrospective chart review was conducted of all bronchiolitis first admissions (N = 295) to the Children’s Hospital at Dartmouth-Hitchcock, CHaD, between 1 November 2010 and 31 October 2017 using the relevant International Classification of Diseases (ICD)-9 and ICD-10 codes for this illness. Abstracted data included laboratory confirmation of RSV infection, severity of illness, duration of hospitalization, age at admission in days, weight at admission, prematurity, siblings, and relevant medical pre-existing conditions. Admissions for bronchiolitis were strongly associated with age of the child, the calendar month of an infant’s birth, and the presence of older children in the family. Medical risk factors associated with admission included premature birth and underlying cardiopulmonary disease. The very early age of hospitalization emphasizes the high penetration of RSV in the community, by implication the limited protection afforded by maternal antibody, and the complexity of protecting infants from this infection. Although risks for respiratory syncytial virus (RSV)/bronchiolitis hospitalization are well described, few studies have examined, with precision, the age-related frequency and severity of RSV/bronchiolitis. We also explore the implications of RSV clinico-epidemiology for our understanding of the pathogenesis of the disease and development of optimal approaches to prevention.
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