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Comparison of Easy-to-Use Bronchiolitis Scores in the Post-COVID-19 Era-An Observational Study
María Del Mar Martín-Latorre1, Leticia Martínez-Campos1, Manuel Martín-González1,2
1Department of Pediatrics, Torrecárdenas University Hospital, 04009 Almeria, Spain.
Insights
The modified Tal score effectively assesses infant bronchiolitis severity post-COVID-19, correlating well with clinical judgment and predicting hospital admission needs. This clinician-friendly tool aids in managing increased bronchiolitis cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Assessment
Background:
- Infant bronchiolitis incidence has risen significantly in the post-COVID-19 era.
- Existing severity assessment scores for bronchiolitis often lack clinical user-friendliness.
- Accurate and simple tools are needed to evaluate disease severity and predict hospitalization.
Purpose of the Study:
- To identify an easy-to-use clinical score for accurately estimating bronchiolitis severity in infants.
- To determine which score best predicts the need for hospital admission.
- To validate the modified Tal score against clinical judgment and other established scales.
Main Methods:
- An observational, cross-sectional study was conducted in a pediatric hospital from 2021-2022.
- Five international acute bronchiolitis scales were compared against clinical severity assessments.
- Three hundred seventy-seven infants diagnosed with acute bronchiolitis participated.
Main Results:
- The Tal score modified by McCallum demonstrated strong correlation with clinical severity (0.836, p < 0.001).
- This modified Tal score showed high concordance with Wang (0.820, p < 0.05) and Wood-Downes-Ferrés (0.936, p < 0.001) scores.
- The modified Tal score's components were significant predictors of hospital admission in multivariate analysis.
Conclusions:
- The modified Tal score is a clinician-friendly instrument for assessing infant bronchiolitis severity at initial contact.
- It exhibits excellent agreement with clinical severity evaluations and predicts hospital admission effectively.
- This score is valuable for managing the increased incidence of bronchiolitis post-COVID-19.
Abstract:
In the post-restrictions COVID-19 period, the incidence of bronchiolitis in infants has increased considerably. Several scores determine the degree of severity of the bronchiolitis episode, but few are clinician-friendly. The main aim of this research was to find the easy-to-use score that most accurately estimated the severity of patients' infections according to their clinical situations and most accurately predicted the need for hospital admission. An observational cross-sectional study was performed in a reference pediatric hospital during the post-restrictions period of the COVID-19 pandemic (2021 and 2022). A comparison was made between the severity estimate provided by five international acute bronchiolitis scales and the clinical severity of the acute bronchiolitis episode. Three hundred and seventy-seven patients participated in the investigation, with a mean age of 5.68 months; 68.7% of the participants had a mild episode of bronchiolitis, 24.5% had a moderate episode, and 6.9% had a severe episode. The severity estimated by the Tal scale modified by McCallum showed a statistically significant correlation with the clinical severity established by clinical criteria (0.836; p < 0.001). It showed a high correlation with other international scores, such as the Wang score (0.820; p < 0.05) and the Wood-Downes-Ferrés score (0.936; p < 0.001). In the multivariate analysis, the constituent variables of the modified Tal score appeared in the final model that predicts the need for hospital admission. In the context of increased incidence after COVID-19, the Tal score modified by McCallum is an easy-to-use measuring instrument that presents an excellent concordance with the clinical severity estimated at first care contact. It also offers a more significant prediction of the need for hospital admission.
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