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A comparison of two clinical scores for bronchiolitis. A multicentre and prospective study conducted in hospitalised infants

2017; Elsevier BV; Volume: 46; Issue: 1 Linguagem: Inglês

10.1016/j.aller.2017.01.012

1578-1267

Cristina Rivas Juesas, J.M. Rius Peris, Ángel M. García-Lora, Ana Amat Madramany, M. García Peris, Lozano Álvarez, J Primo,

Viral gastroenteritis research and epidemiology

There are a number of clinical scores for bronchiolitis but none of them are firmly recommended in the guidelines. 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. 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. 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.