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2016 FI

1.439
© Thomson Reuters, Journal Citation Reports, 2016

Indexed in:

Index Medicus/Medline, Excerpta Medica/EMBASE, IBECS, IME Cancerlit, Bibliomed, CabHealth, Scisearch, HealthStar, Scopus, Prous, Science Intergews, Science Citation Index Expanded.

Metrics

  • Impact Factor: 1.439 (2016)
  • SCImago Journal Rank (SJR):0,38
  • Source Normalized Impact per Paper (SNIP):0,591

© Thomson Reuters, Journal Citation Reports, 2016

Allergol Immunopathol (Madr) 2018;46:15-23 - DOI: 10.1016/j.aller.2017.01.012
Original Article
A comparison of two clinical scores for bronchiolitis. A multicentre and prospective study conducted in hospitalised infants
C. Rivas-Juesasa,, , J.M. Rius Perisb, A.L. Garcíaa, A.A. Madramanyc, M.G. Perisd, L.V. Álvareze, J. Primoa
a Hospital de Sagunto, Avda Ramón y Cajal s.n, Sagunto, 46520 Valencia, Spain
b Hospital Virgen de la Luz, Hermandad de Donantes de Sangre n° 1, 16002 Cuenca, Spain
c Hospital Universitario de La Ribera, Carretera de Corbera s/n, Alzira 46600, Spain
d Hospital LLuis Alcanyís, Crta, Xátiva a Silla Km 2, Xátiva, 46800 Valencia, Spain
e Hospital de Vinaroz, Castellón, Spain
Received 10 December 2016, Accepted 26 January 2017
Abstract
Background

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

Method

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.

Results

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.

Conclusions

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.

Abbreviations
ESBA, WDF, AUC, ROC, Se, Sp, LR+, LR−, ICU
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