Estudio clinicoepidemiológico de la bronquiolitis aguda

Abstract

Objective To determine the incidence of hospital admissions forbronchiolitis in our environment, to analyze the importance of neonatal malformations as a risk factor for hospitalization for bronchiolitis and to establish the variables available on admission that are associated with aworse evolution. Design and patiens Descriptive study of admissions for bronchiolitis in asample of the general population and in children with severe neonatal malformations. Descriptive and analyticalstudy of the clinical characteristics available on admissionfor bronchiolitis that predict a worse evolution. Sixtyonechildren born at the Medina del Campo Hospital in Spainwere studied. All the children were diagnosed according to McConnochie's criteria and classified into three groupsaccording to evolution (mild, moderate and severe). Results The annual cumulative incidence of admissions due tobronchiolitis was 1.79 % (95 % CI, –2.30). This incidence was higher in children with a history of severe neonatalmalformations (13.11 %) than in those without malformations (1.59 %) (RR58.26; CI 95 %, –16.02). Childrenwith severe bronchiolitis were younger (p50.0056; median 1.0, quartiles –2.75) than those with moderatebronchiolitis (median 5.0; quartiles –8.0) or mild bronchiolitis (median 5.5; quartiles –9.0). Using the groupwith mild bronchiolitis as reference, diminished appetite(OR54.08; 95 % CI, –16.80), vomiting (OR54.22; 95 %CI, –25.30) and prolonged expiration (OR55.35, 95 %CI, –24.30) were associated with moderate-severe evolution. Using the mildmoderate group as reference, vomiting (p50.004), crepitant rales (p50.002), decreasedventilation (p,0.001) and radiological consolidations(p50.017) were associated with severe evolution. Conclusions The incidence of hospital admission for bronchiolitis inour environment was similar to data reported from othercountries. Variables available at admission predicting aworse evolution were age lower than 3 months, vomiting,diminished appetite, prolonged expiration, crepitant rales,decreased ventilation and radiological consolidations. Severe neonatal malformations were an important risk factorfor hospital admission due to bronchiolitis.