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[Apnoea in infants with bronchiolitis: Incidence and risk factors for a prediction model]
José Miguel Ramos-Fernández1, David Moreno-Pérez2, Mario Gutiérrez-Bedmar3
1Sección de Lactantes, Unidad de Gestión Clínica de Pediatría, Grupo de Investigación IBIMA, Hospital Materno-Infantil Hospital Regional Universitario de Málaga, Málaga, España.
Insights
This study found that 4.4% of hospitalized infants with acute bronchiolitis (AB) experienced apnea. Key risk factors include cesarean delivery, low postmenstrual age, low birth weight, and severe bacterial infection, aiding in early risk identification.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Critical Care Medicine
Background:
- Apnea is a significant complication of acute bronchiolitis (AB), with reported incidence varying widely.
- Understanding the incidence and risk factors for apnea in hospitalized AB patients is crucial for effective management.
Purpose of the Study:
- To determine the incidence of apnea in hospitalized patients diagnosed with acute bronchiolitis.
- To identify associated risk factors for apnea in this population.
- To develop a predictive model for apnea risk in acute bronchiolitis.
Main Methods:
- A retrospective observational study was conducted on 1,197 patients admitted with acute bronchiolitis.
- Data on apnea frequency and clinical variables were collected.
- Binary logistic regression and ROC curve analysis were used to identify risk factors and develop a prediction model.
Main Results:
- The incidence of apnea during admission for acute bronchiolitis was 4.4% (53 out of 1,197 patients).
- Significant risk factors identified included cesarean delivery, postmenstrual age ≤43 weeks, low birth weight, apnea observed by caregivers before admission, and severe bacterial infection.
- The prediction model demonstrated high accuracy with an optimal sensitivity of 0.842 and specificity of 0.846.
Conclusions:
- The incidence of apnea in hospitalized acute bronchiolitis patients is 4.4%.
- A validated prediction model incorporating identified risk factors can assist clinicians in classifying patients at increased risk of apnea.
- Early identification and risk stratification can potentially improve patient outcomes.
Introduction:
The presence of apnoea in acute bronchiolitis (AB) varies between 1.2% and 28.8%, depending on the series, and is one of its most fearsome complications. The aim of this study is to determine the incidence of apnoea in hospitalised patients diagnosed with AB, and to define their associated risk factors in order to construct a prediction model.
Patients And Method:
A retrospective observational study of patients admitted to a tertiary hospital in the last 5 years with a diagnosis of AB, according to the classic criteria. Data was collected on the frequency of apnoea and related clinical variables to find risk factors in a binary logistic regression model for the prediction of apnoea. A ROC curve was developed with the model.
Results:
Apnoea was recorded during the admission of 53 (4.4%) patients out of a total 1,197 cases found. The risk factors included in the equation were: Female (OR 0.6, 95% CI: 0.27-1.37), Caesarean delivery (OR: 3.44, 95% CI: 1.5-7.7), Postmenstrual age ≤43 weeks (OR: 6.62, 95% CI: 2.38-18.7), Fever (OR: 0.33, 95% CI: 0.09-1.97), Low birth weight (OR: 5.93, 95% CI: 2.23-7.67), Apnoea observed by caregivers before admission (OR: 5.93, 95% CI: 2.64-13.3), and severe bacterial infection (OR: 3.98, 95% CI: 1.68-9.46). The optimal sensitivity and specificity of the model in the ROC curve was 0.842 and 0.846, respectively (P<.001).
Conclusions:
The incidence of apnoea during admission was 4.4 per 100 admissions of AB and year. The estimated prediction model equation may be of help to the clinician in order to classify patients with increased risk of apnoea during admission due to AB.
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