A predictive model for respiratory syncytial virus (RSV) hospitalisation of premature infants born at 33–35 weeks of gestational age, based on data from the Spanish FLIP study

Simões, Eric A F; Carbonell‐Estrany, Xavier; Fullarton, John R.; Liese, Johannes G.; J, Figueras Aloy; Doering, Gunther; Guzmán, Juana

doi:10.1186/1465-9921-9-78

Cited by 77 publications

(80 citation statements)

References 23 publications

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“…Until now, RSV specific data on unselected healthy children were lacking. Several prediction models for RSV hospitalisation in infants have been published [18,23,24], but none incorporated neonatal lung function measurements.…”

Section: Discussionmentioning

confidence: 99%

Decreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants

et al. 2014

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It is unknown why respiratory syncytial virus (RSV) causes mild disease in some children and severe disease, requiring hospitalisation, in others. We aimed to assess whether diminished premorbid lung function in healthy term infants predisposes to hospitalisation during RSV bronchiolitis, and to post-RSV wheeze.In a prospective birth cohort study of unselected term healthy children, neonatal lung function was measured before the age of 2 months (n52133). From birth through the first year of life, respiratory symptoms were recorded in a diary, and general practitioner consultations and hospitalisations were documented. In a subgroup (n5417) repeated nose and throat swabs were collected for PCR to detect RSV infections.Median neonatal respiratory system compliance (Crs) was significantly lower (41.2 versus 47.4 mL?kPa -1 , p50.03) and resistance (Rrs) was higher (8.2 versus 6.3 kPa?s?L -1 , p50.10) in hospitalised RSV patients (n518) compared with nonhospitalised RSV-positive infants (n584). Every 10 mL?kPa -1 increase in Crs was associated with 55% less post-RSV wheeze (OR 0.56, 95% CI 0.35-0.90), and each kPa?s?L -1 increase in Rrs was associated with 42% more post-RSV wheeze, which was only marginally explained by pre-RSV wheeze or severity of the RSV disease.This unselected birth cohort study shows for the first time that decreased lung function at birth predisposes to severe RSV disease, and to post-RSV wheeze. @ERSpublications Impaired neonatal lung function precedes a severe course of RSV infection in unselected children

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Section: Discussionmentioning

confidence: 99%

Decreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants

et al. 2014

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“…To be financially viable, palivizumab is provided to only those children at high risk for complicated RSV hospitalization rather than to all children [144].…”

Section: Predicting Rsv Hospitalizationmentioning

confidence: 99%

“…To help clinicians identify the best candidates for palivizumab immunization, a model is often used to predict the likelihood that a specific child will experience RSV hospitalization in the next few months [144].…”

Section: Predicting Rsv Hospitalizationmentioning

confidence: 99%

“…For infants in this cohort, Simões et al [144] used discriminatory function analysis to build a model to predict RSV hospitalization. On various data sets, the predictive model achieved an AUC of 63-79%, a classification accuracy of 66-77%, a sensitivity of 46-75%, a specificity of 67-79%, a positive predictive value of 10-75%, and a negative predictive value of 73-96% [138,144,[148][149][150].…”

Section: Predicting Rsv Hospitalizationmentioning

confidence: 99%

“…To build such predictive models, we can use the predictors of RSV/bronchiolitis hospitalization that have already been identified in the literature for young children born at various gestational stages [60-63, 66, 96, 131, 141, 144, 145, 152-159, 161-182]. We can consider certain chronic conditions, such as congenital heart disease, chronic lung disease, and severe neurological diseases, which may increase the risk of RSV hospitalization, but are ignored in existing predictive models [144]. We can make prediction on a monthly basis, in a way similar to that in Rietveld et al [33], accounting for community viral prevalence, prevailing weather patterns [183][184][185], etc.…”

Section: Predicting Rsv Hospitalizationmentioning

confidence: 99%

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A systematic review of predictive modeling for bronchiolitis

Luo

Nkoy

Gesteland

et al. 2014

International Journal of Medical Informatics

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Purpose: Bronchiolitis is the most common cause of illness leading to hospitalization in young children. At present, many bronchiolitis management decisions are made subjectively, leading to significant practice variation among hospitals and physicians caring for children with bronchiolitis. To standardize care for bronchiolitis, researchers have proposed various models to predict the disease course to help determine a proper management plan. This paper reviews the existing state of the art of predictive modeling for bronchiolitis. Predictive modeling for respiratory syncytial virus (RSV) infection is covered whenever appropriate, as RSV accounts for about 70% of bronchiolitis cases.Methods: A systematic review was conducted through a PubMed search up to April 25, 2014. The literature on predictive modeling for bronchiolitis was retrieved using a comprehensive search query, which was developed through an iterative process.Search results were limited to human subjects, the English language, and children (birth-18 years). Results:The literature search returned 2,312 references in total. After manual review, 168 of these references were determined to be relevant and are discussed in this paper. We identify several limitations and open problems in predictive modeling for bronchiolitis, and provide some preliminary thoughts on how to address them, with the hope to stimulate future research in this domain. Conclusions:Many problems remain open in predictive modeling for bronchiolitis. Future studies will need to address them to achieve optimal predictive models.

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Appropriateness of Age Thresholds for Respiratory Syncytial Virus Immunoprophylaxis in Moderate-Preterm Infants

et al. 2013

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IMPORTANCE Recommendations concerning the appropriate age threshold for respiratory syncytial virus (RSV) prophylaxis in moderate-preterm infants are highly debated. OBJECTIVE To determine the age at which moderate-preterm infants' risk of RSV hospitalization has decreased to the risk observed in low-risk term infants. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of Florida and Texas Medicaid fee-for-service billing records matched to birth certificates from Medicaid beneficiaries aged 0 to 12 months with a sibling younger than 5 years and without other indications for RSV prophylaxis between January 1, 1999, and December 31, 2004. EXPOSURES For each state, we used discrete time survival analysis to develop age trend models for RSV hospitalizations for 2 groups: moderate-preterm infants (32-34 weeks' gestational age) and term infants (37-41 weeks' gestational age). MAIN OUTCOMES AND MEASURES Age at which preterm infants' risk of RSV hospitalization equaled the risk for term infants at age 1 month. RESULTS Our cohort included 247,566 eligible infants with 5322 RSV hospitalizations. Preterm status doubled the risk for RSV hospitalization in both Florida (odds ratio = 2.41; 95% CI, 1.85-3.12) and Texas (odds ratio = 1.94; 95% CI, 1.64-2.30). Preterm infants' risk of RSV hospitalization was similar to that for 1-month-old term infants at ages 4.2 months (95% CI, 2.5-5.7) in Florida and 4.5 months (95% CI, 2.8-6.4) in Texas. CONCLUSIONS AND RELEVANCE The age at which moderate-preterm infants showed RSV hospitalization risk similar to their healthy term counterparts supports the more restrictive age thresholds in RSV immunoprophylaxis recommendations. Further studies are warranted to investigate the age-dependent risk of RSV hospitalization in other RSV risk groups.

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A predictive model for respiratory syncytial virus (RSV) hospitalisation of premature infants born at 33–35 weeks of gestational age, based on data from the Spanish FLIP study

Abstract: Background: The aim of this study, conducted in Europe, was to develop a validated risk factor based model to predict RSV-related hospitalisation in premature infants born 33-35 weeks' gestational age (GA).

Cited by 77 publications

References 23 publications

Decreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants

Decreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants

A systematic review of predictive modeling for bronchiolitis

Appropriateness of Age Thresholds for Respiratory Syncytial Virus Immunoprophylaxis in Moderate-Preterm Infants

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