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[Epidemiology, clinical features and medical interventions in children hospitalized for bronchiolitis]
J A Piñero Fernández1, S Alfayate Migueléz, A Menasalvas Ruiz
1Sección de Enfermedades Infecciosas Pediátricas, Hospital Virgen de la Arrixaca, Murcia, España. japf35@hotmail.com
Insights
Infant bronchiolitis is common in the first months of life, with maternal smoking linked to worse outcomes. Overuse of treatments was observed despite guidelines.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of respiratory infections
- Clinical management of viral illnesses
Context:
- Bronchiolitis is a leading cause of infant hospitalization.
- Understanding risk factors and treatment patterns is crucial for improving care.
- This study focuses on a Spanish cohort during peak season.
Purpose:
- To detail the epidemiology of childhood bronchiolitis.
- To characterize clinical presentations and prescribed treatments.
- To identify factors influencing hospitalization and therapy duration.
Summary:
- A prospective study of 235 infants under 18 months with bronchiolitis found 78.7% were 5 months or younger.
- Maternal smoking during pregnancy and non-breastfeeding correlated with increased oxygen therapy days.
- Respiratory Syncytial Virus (RSV) was the primary pathogen; diagnostic and pharmacologic interventions were frequently used.
Impact:
- Highlights the significant impact of maternal smoking on infant bronchiolitis severity.
- Suggests potential areas for guideline adherence improvement regarding diagnostic and treatment strategies.
- Informs public health initiatives and clinical practice for pediatric respiratory infections.
Objectives:
To describe the epidemiology, clinical characteristics and treatments prescribed in children with bronchiolitis admitted to our hospital.
Material And Methods:
Observational, descriptive and prospective study of children younger than 18 months, admitted to Hospital Virgen de la Arrixaca of Murcia (Spain), with the diagnosis of bronchiolitis, during the season of maximum incidence (December 2008-April 2009).
Results:
A total of 235 infants were admitted, of whom 78.7% of them were aged 5 months or less. We found a positive correlation between the number of cigarettes smoked by their mothers during pregnancy and the number of hospitalization and oxygen therapy days. Children whose mothers were smokers at the time of their admission needed a greater number of oxygen therapy days. Also infants who were not breastfed needed oxygen therapy during more days. Just under one quarter (23.8%) of them had underlying diseases, with prematurity being the most frequent and a risk factor for the ongoing of oxygen therapy and hospital stay. The use of diagnostic tests, bronchodilators, corticosteroids and antibiotics was high. The onset of high temperature was associated with an increased use of antibiotics in outside and inside the hospital setting. An abnormal chest X-ray or a raised C-reactive protein was associated with a higher use of antibiotics. Respiratory Syncytial virus (RSV) was the main aetiological agent, followed by Rhinovirus, Bocavirus, Adenovirus and Metapneumovirus
Conclusions:
The majority of hospital admissions due to bronchiolitis took place during the first months of life. Infants whose mothers smoked during pregnancy had a worse clinical outcome. Despite the availability of clinical practice guidelines in our area, the use of diagnostic tests and pharmacological treatment was high.
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