Modified Tal Score as a Predictor of Outcome in Bronchiolitis: A Cross-Sectional Study in Nepal

Introduction Bronchiolitis is a leading cause of respiratory distress and hospitalizations among infants and young children worldwide. Despite its prevalence, predicting the severity and outcomes of bronchiolitis remains challenging. Standardized criteria for severity assessment are essential for improving patient care and resource allocation. The modified Tal score is a reliable tool for assessing the severity of bronchiolitis. This study examines the relationship between the modified Tal score at presentation and key clinical outcomes in children with bronchiolitis. Methods This cross-sectional study classified children with bronchiolitis into mild, moderate, and severe groups using the modified Tal score at presentation. Patients were followed to record the length of hospital stay, duration of oxygen therapy, and the need for pediatric intensive care unit (PICU) or escalated care. Results Of the 121 children analyzed, the majority (71.9%) were aged three to 11 months, with a mean age of 9.09 months, and 73.6% were male. Oxygen supplementation was required by 60.3% of participants, 10.7% needed PICU admission, and 2.5% required escalated care. The mean duration of oxygen therapy was significantly longer in the severe group compared to the mild and moderate groups (p<0.001). Hospital stays also increased with severity (p<0.001). Linear regression showed that each unit increase in the modified Tal score resulted in a 0.746-day rise in hospital stay, a 10.19-hour increase in oxygen requirement, and a 0.35-day increase in PICU stay (all p<0.001). The score accounted for 66.1% of the variability in hospital stay, 63.0% in oxygen requirement, and 53.3% in PICU stay, but only 9.5% in escalated care. Conclusion A higher modified Tal score at admission was associated with prolonged hospitalization, increased oxygen requirement duration, and greater need for PICU admission in bronchiolitis. However, the modified Tal score was not a strong determinant of the requirement for escalated care.