ArticlePediatrics2018
Predicting Escalated Care in Infants With Bronchiolitis.
Article in Pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 55 citations in OpenAlex.
- Application of machine learning to predict bronchiolitis severity in children: a single-centre retrospective cohort study.European journal of pediatrics · 2026Article
- Article
- Infants with bronchiolitis with high-flow nasal cannula in the paediatric ward. Is there a role for the ROXi (respiratory rate-oxygenation index) in predicting failure of high-flow nasal cannula?European journal of pediatrics · 2025Observational
- Modified Tal Score as a Predictor of Outcome in Bronchiolitis: A Cross-Sectional Study in Nepal.Cureus · 2024Article
- Article
- Respiratory Syncytial Virus Infection and Apnea Risk As Criteria for Hospitalization in Full Term Healthy Infants.Cureus · 2024Article
- Factors associated with mild bronchiolitis in young infants.Journal of the American College of Emergency Physicians open · 2023Article
- Comparison of severity scales for acute bronchiolitis in real clinical practice.European journal of pediatrics · 2023Review
- Stakeholder Perspectives on Hospitalization Decisions and Shared Decision-Making in Bronchiolitis.Hospital pediatrics · 2022Article
- What Is the Role of Shared Decision-Making With Parents of Children With Bronchiolitis?Hospital pediatrics · 2022Article
- Risk Factors Associated with Mechanical Ventilation in Critical Bronchiolitis.Children (Basel, Switzerland) · 2021Article
- Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method.Children (Basel, Switzerland) · 2021Article
- The Pediatric Emergency Research Network: A Decade of Global Research Cooperation in Pediatric Emergency Care.Pediatric emergency care · 2021Article
- [Predictors of hospitalization plus airway support among infants with recurrent wheezing in the emergency department].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2021Article
- Machine learning-based prediction of acute severity in infants hospitalized for bronchiolitis: a multicenter prospective study.Scientific reports · 2020Article
- Characterizing Avoidable Transfer Admissions in Infants Hospitalized for Bronchiolitis.Hospital pediatrics · 2020Article
- Article
- Article
- National survey of feasibility of NIV trials for management of children with bronchiolitis.BMJ paediatrics open · 2020Article
- Overcoming the Bronchiolitis Blues: Embracing Global Collaboration and Disease Heterogeneity.Pediatrics · 2018Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
20 authors at 16 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesEarly risk stratification of infants with bronchiolitis receiving airway support is critical for focusing appropriate therapies, yet the tools to risk categorize this subpopulation do not exist. Our objective was to identify predictors of "escalated care" in bronchiolitis. We hypothesized there would be a significant association between escalated care and predictors in the emergency department. We subsequently developed a risk score for escalated care.
methodsWe conducted a retrospective cohort study of previously healthy infants aged <12 months with bronchiolitis. Our primary outcome was escalated care (ie, hospitalization with high-flow nasal cannula, noninvasive or invasive ventilation, or intensive care admission). The predictors evaluated were age, prematurity, day of illness, poor feeding, dehydration, apnea, nasal flaring and/or grunting, respiratory rate, oxygen saturation, and retractions.
resultsOf 2722 patients, 261 (9.6%) received escalated care. Multivariable predictors of escalated care were oxygen saturation <90% (odds ratio [OR]: 8.9 [95% confidence interval (CI) 5.1-15.7]), nasal flaring and/or grunting (OR: 3.8 [95% CI 2.6-5.4]), apnea (OR: 3.0 [95% CI 1.9-4.8]), retractions (OR: 3.0 [95% CI 1.6-5.7]), age ≤2 months (OR: 2.1 [95% CI 1.5-3.0]), dehydration (OR 2.1 [95% CI 1.4-3.3]), and poor feeding (OR: 1.9 [95% CI 1.3-2.7]). One of 217 (0.5%) infants without predictors received escalated care. The risk score ranged from 0 to 14 points, with the estimated risk of escalated care from 0.46% (0 points) to 96.9% (14 points). The area under the curve was 85%.
conclusionsWe identified variables measured in the emergency department predictive of escalated care in bronchiolitis and derived a risk score to stratify risk of this outcome. This score may be used to aid management and disposition decisions.
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