A comparison of two clinical scores for bronchiolitis. A multicentre and prospective study conducted in hospitalised infants
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C. Rivas-Juesas [1] ; J.M. Rius Peris [2] ; A.L. García [1] ; A.A. Madramany [4] ; M.G. Peris [3] ; L.V. Álvarez [5] ; J. Primo [1]
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[1] Hospital de Sagunto
Hospital de Sagunto
Sagunto/Sagunt, España
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[2] Hospital Virgen de La Luz de Cuenca
Hospital Virgen de La Luz de Cuenca
Cuenca, España
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[3] Hospital Xàtiva Lluis Alcanyis
Hospital Xàtiva Lluis Alcanyis
Játiva, España
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[4] Hospital Universitario de La Ribera, Alzira
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[5] Hospital de Vinaroz, Castellón
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- Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 46, Nº. 1, 2018, págs. 15-23
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
- Dialnet Métricas: 1 Cita
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Resumen
Background There are a number of clinical scores for bronchiolitis but none of them are firmly recommended in the guidelines.
Method We designed a study to compare two scales of bronchiolitis (ESBA and Wood Downes Ferres) and determine which of them better predicts the severity. A multicentre prospective study with patients <12 months with acute bronchiolitis was conducted. Each patient was assessed with the two scales when admission was decided. We created a new variable “severe condition” to determine whether one scale afforded better discrimination of severity. A diagnostic test analysis of sensitivity and specificity was made, with a comparison of the AUC. Based on the optimum cut-off points of the ROC curves for classifying bronchiolitis as severe we calculated new Se, Sp, LR+ and LR− for each scale in our sample.
Results 201 patients were included, 66.7% males and median age 2.3 months (IQR=1.3–4.4). Thirteen patients suffered bronchiolitis considered to be severe, according to the variable severe condition. ESBA showed a Se=3.6%, Sp=98.1%, and WDF showed Se=46.2% and Sp=91.5%.
The difference between the two AUC for each scale was 0.02 (95%CI: 0.01–0.15), p=0.72. With new cut-off points we could increase Se and Sp for ESBA: Se=84.6%, Sp=78.7%, and WDF showed Se=92.3% and Sp=54.8%; with higher LR.
Conclusions None of the scales studied was considered optimum for assessing our patients. With new cut-off points, the scales increased the ability to classify severe infants. New validation studies are needed to prove these new cut-off points.
