Risk factors for bronchiolitis-associated deaths among infants in the United States

Holman, Robert C.; Shay, David K.; Curns, Aaron T.; Lingappa, Jairam R.; Anderson, Larry J.

doi:10.1097/01.inf.0000069765.43405.3b

Cited by 151 publications

(104 citation statements)

References 41 publications

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“…Furthermore, many studies included a large number of premature infants, a condition that is closely related with low birthweight, thus hampering independent evaluation of this factor. Some recent studies have found that low birthweight independently increases the risk of hospitalization due to RSV infection [11,20,21] and the risk of RSV-associated death [3,15]. Our results reinforce the observation that low birthweight should be considered as an underlying condition that increases the severity of RSV-related illness.…”

Section: Discussionsupporting

confidence: 89%

“…Both factors are associated with low socio-economic status, a factor that we have not been able to investigate, but which has been related to a greater risk of severe RSV infections [1,2]. Recently, young maternal age has been independently associated with a higher risk of bronchiolitis-associated deaths in the United States [15]. Interestingly, 5 % of the infants hospitalized in that study belonged to the gypsy ethnic group, a proportion higher than that in our population, which, lacking official statistics, we estimate is lower than 1 % [16].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain

et al. 2005

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SUMMARYThis study analysed the role of several risk factors for hospitalization due to communityacquired, respiratory syncytial virus (RSV) infection. The risk factors detected in infants hospitalized for RSV infection in the first 24 months of life were compared with those in the general infant population in our region. There were 361 episodes of hospitalization in 357 infants. Eighty per cent of the infants did not present underlying conditions for severe RSV infection and only 10 (3 %) were candidates for palivizumab prophylaxis. In multivariate analysis, birthweight of <2500 g was independently associated with hospitalization for RSV infection and was the most commonly detected medical risk factor. Other risk factors were maternal age at delivery <25 years, birth in the second half of the year, prematurity, suburban residence and congenital heart disease. In conclusion, together with well-known risk factors, we found that low birthweight was an independent factor for severe RSV infection.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain

et al. 2005

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“…15 Use of palivizumab was generally consistent with the AAP guidelines at the time of enrollment 15,16 and published literature on potential risk factors for RSV morbidity, such as prematurity and child-care attendance, 8 and low birth weight (LBW; <2500 g). 22,23 Based on cumulative data, approximately 90% of infants were premature, 83% had LBW and 47% were enrolled in child-care or were exposed to another child in the household who attended child care. The definition of child-care attendance was left to the discretion of each site.…”

Section: Discussionmentioning

confidence: 99%

Prevention of hospitalization due to respiratory syncytial virus: results from the Palivizumab Outcomes Registry

Frogel

Nerwen

Cohen³

et al. 2008

J Perinatol

103

108

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Objective: The Palivizumab Outcomes Registry contains data on infants and young children who received palivizumab for the prevention of respiratory syncytial virus (RSV) that causes serious lower respiratory tract illness.Study Design: Prospective observational registry enrolling those who received X1 dose of palivizumab during any RSV season (2000 to 2004) at participating US sites.Result: Of 19 548 subjects enrolled, 40% were born before 32 weeks', 48% between 32 and 35 weeks' and 12% after 35 weeks' gestation. Risk factors included child-care attendance, prematurity, chronic lung disease (CLD) and congenital heart disease (CHD). The RSV hospitalization rate of palivizumab recipients was 1.3%. Gender, gestational age <32 weeks, CLD, CHD, congenital airway abnormality, severe neuromuscular disease, Medicaid insurance and >2 children in household were associated with significantly higher rates. Home-care prophylaxis with palivizumab was associated with reduced hospitalization rates.Conclusion: Data on the use of palivizumab prophylaxis in primarily high-risk infants confirm low RSV hospitalization rates.

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“…Obstruction can lead to atelectasis, which can further worsen breathing and respiratory function. Epidemiological studies 4 have shown that bronchiolitis infection is associated with a high degree of morbidity but low mortality.…”

Section: Definition and Pathophysiologymentioning

confidence: 99%

Hypertonic Saline for the Treatment of Bronchiolitis in Infants and Young Children: A Critical Review of the Literature

Baron

El-Chaar

2016

The Journal of Pediatric Pharmacology and Therapeutics

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Bronchiolitis, an infection of the lower respiratory tract, is the leading cause of infant and child hospitalization in the United States. Therapeutic options for management of bronchiolitis are limited. Hypertonic saline inhalation therapy has been studied in numerous clinical trials with mixed results. In 2014, the American Academy of Pediatrics (AAP) published updated guidelines on the diagnosis and management of bronchiolitis, which include new recommendations on the use of hypertonic saline. We reviewed all published clinical trials mentioned in the 2014 AAP guidelines, as well as additional trials published since the guidelines, and critically evaluated each trial to determine efficacy, safety, and expectations of hypertonic saline inhalation therapy. A total of 2682 infants were studied over the course of 22 clinical trials. Nine trials were carried out in the outpatient/clinic/emergency department and 13 in the inpatient setting. We agree with the AAP guidelines regarding the recommendation to use nebulized hypertonic saline for infants hospitalized with bronchiolitis, with the expectation of reducing bronchiolitis scores and length of stay when it is expected to last more than 72 hours. However, we also believe there might be an advantage for hypertonic saline in reducing admission rates from the emergency department, based on close examination of the results of recent trials. This review also highlights important gaps in the available literature that need to be addressed in order to define the role of inhaled hypertonic saline therapy.INDEX TERMS: bronchiolitis, hypertonic saline, infants, pediatrics, review J Pediatr Pharmacol Ther 2016;21(1):7-26

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Risk factors for bronchiolitis-associated deaths among infants in the United States

Cited by 151 publications

References 41 publications

Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain

Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain

Prevention of hospitalization due to respiratory syncytial virus: results from the Palivizumab Outcomes Registry

Hypertonic Saline for the Treatment of Bronchiolitis in Infants and Young Children: A Critical Review of the Literature

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