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

S Rödl1, B Resch, N Hofer

  • 1Paediatric Intensive Care Unit, Department of Paediatrics, Medical University of Graz, Graz, Austria.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|April 25, 2012
PubMed

Insights

This study compared illness severity scoring systems in infants with bronchiolitis. Respiratory Syncytial Virus (RSV)-positive infants showed significantly higher scores, indicating more severe illness.

Area of Science:

  • Pediatrics
  • Intensive Care Medicine
  • Infectious Diseases

Background:

  • Bronchiolitis is a common respiratory infection in infants.
  • Assessing illness severity in infants with bronchiolitis is crucial for appropriate care.
  • Existing scoring systems may vary in their effectiveness for this population.

Purpose of the Study:

  • To compare the performance of three scoring systems: Pediatric Risk of Mortality III (PRISM III), Organ System Failure (OSF), and Acute Physiologic Score for Children (APSC).
  • To evaluate these scores in infants with bronchiolitis admitted to a tertiary pediatric intensive care unit (PICU).
  • To determine if respiratory syncytial virus (RSV) association impacts scoring system outcomes.

Main Methods:

  • A prospective study over 18 years (1990-2007) involving infants up to 12 months old admitted to the PICU with bronchiolitis.
  • Infants were scored within 24 hours using PRISM III, OSF, and APSC.
  • Comparison between RSV-positive and RSV-negative infants.

Main Results:

  • No significant differences in gestational age, birth weight, or bronchopulmonary dysplasia between RSV-positive and RSV-negative groups.
  • Significantly higher PRISM III, OSF, and APSC scores in RSV-positive infants compared to RSV-negative infants.
  • All scoring systems showed significantly higher values in infants requiring mechanical ventilation.

Conclusions:

  • RSV-positive bronchiolitis is associated with higher illness severity as indicated by PRISM III, OSF, and APSC scores.
  • The scoring systems effectively differentiate severity in infants with bronchiolitis, particularly when RSV is present.
  • These findings support the use of these scoring systems for assessing bronchiolitis severity in the PICU.

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