Shu-Ling Chong1, Oon Hoe Teoh2, Nivedita Nadkarni3, Joo Guan Yeo4, Zaw Lwin1, Yong-Kwang Gene Ong1, Jan Hau Lee5. 1. Department of Emergency Medicine, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore. 2. Department of Paediatrics, Respiratory Medicine Service, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore. 3. Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore. 4. Division of Medicine, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore. 5. Children's Intensive Care Unit, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore.
Abstract
BACKGROUND AND OBJECTIVE: Bronchiolitis is a common disease in early childhood with increasing healthcare utilization. We aim to study how well a simple and improved respiratory score (the modified Respiratory Index Score [RIS]) would perform when predicting for a warranted admission. METHODS: This is an observational prospective study, from June 2015 to December 2015 in a paediatric emergency department (ED) of a large tertiary hospital in Singapore. We included children aged less than 2 years old, presenting with typical symptoms and signs of bronchiolitis but excluded children with four or more previous wheezes, a gestation of <35 weeks, and known cardiopulmonary disease. We also performed a sensitivity analysis for children presenting with their first wheeze. We defined a warranted admission as a composite of: The need for airway intervention, intravenous hydration, and a hospital stay of 2 days or more. RESULTS: Among 1,818 patients, the median age was 10.8 months (IQR 7.2-15.9). The median modified RIS score was 4.0 (IQR 3.0-5.0). A total of 19 (1.0%) children required respiratory support, 101 (5.6%) received intravenous hydration, and 571 (31.4%) required a hospital stay of 2 days or more. After adjusting for age and duration of illness, a modified RIS score of >4 predicted significantly for a warranted admission (adjusted Odds Ratio: 3.28, 95% confidence interval: 2.62-4.12). The association remained significant among children presenting with their first wheeze. CONCLUSIONS: This simple respiratory tool predicts for the need for respiratory support, intravenous hydration, and a significant hospital stay of 2 days or more. Pediatr Pulmonol. 2017; 52:954-961.
BACKGROUND AND OBJECTIVE:Bronchiolitis is a common disease in early childhood with increasing healthcare utilization. We aim to study how well a simple and improved respiratory score (the modified Respiratory Index Score [RIS]) would perform when predicting for a warranted admission. METHODS: This is an observational prospective study, from June 2015 to December 2015 in a paediatric emergency department (ED) of a large tertiary hospital in Singapore. We included children aged less than 2 years old, presenting with typical symptoms and signs of bronchiolitis but excluded children with four or more previous wheezes, a gestation of <35 weeks, and known cardiopulmonary disease. We also performed a sensitivity analysis for children presenting with their first wheeze. We defined a warranted admission as a composite of: The need for airway intervention, intravenous hydration, and a hospital stay of 2 days or more. RESULTS: Among 1,818 patients, the median age was 10.8 months (IQR 7.2-15.9). The median modified RIS score was 4.0 (IQR 3.0-5.0). A total of 19 (1.0%) children required respiratory support, 101 (5.6%) received intravenous hydration, and 571 (31.4%) required a hospital stay of 2 days or more. After adjusting for age and duration of illness, a modified RIS score of >4 predicted significantly for a warranted admission (adjusted Odds Ratio: 3.28, 95% confidence interval: 2.62-4.12). The association remained significant among children presenting with their first wheeze. CONCLUSIONS: This simple respiratory tool predicts for the need for respiratory support, intravenous hydration, and a significant hospital stay of 2 days or more. Pediatr Pulmonol. 2017; 52:954-961.
Authors: Kathryn M Schmit; Roger Brown; Supriya Hayer; Mary M Checovich; James E Gern; Ellen R Wald; Bruce Barrett Journal: Pediatr Res Date: 2021-02-24 Impact factor: 3.756