Buscar en
Allergologia et Immunopathologia
Toda la web
Inicio Allergologia et Immunopathologia A comparison of two clinical scores for bronchiolitis. A multicentre and prospec...
Journal Information
Vol. 46. Issue 1.
Pages 15-23 (January - February 2018)
Share
Share
Download PDF
More article options
ePub
Vol. 46. Issue 1.
Pages 15-23 (January - February 2018)
Original Article
DOI: 10.1016/j.aller.2017.01.012
A comparison of two clinical scores for bronchiolitis. A multicentre and prospective study conducted in hospitalised infants
Visits
...
C. Rivas-Juesasa,
Corresponding author
rivas_cri@gva.es

Corresponding author.
, 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
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (7)
Table 1. Comparison of the epidemiological and clinical characteristics of the patients with acute bronchiolitis according to severity.
Table 2. Agreement among scales. Weighted kappa coefficient.
Table 3. Analysis of sensitivity, specificity, PPV, NPV and likelihood ratios of the cases of bronchiolitis in reference to the WDF scale.
Table 4. Analysis of sensitivity, specificity, PPV, NPV and likelihood ratios of the cases of bronchiolitis in reference to the ESBA scale.
Table 5. Analysis of sensitivity, specificity, PPV, NPV and likelihood ratios of the cases of bronchiolitis in reference to the WDF and ESBA scale, with the cut-off points derived from the study sample. Estimation of the Youden index (J) and optimum cut-off point (c*) of the scale for the sample (WDF >5 points and ESBA >6 points).
Show moreShow less
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.

Keywords:
Bronchiolitis
Infants
Clinical scores
Diagnostic test
ROC curves
Abbreviations:
ESBA
WDF
AUC
ROC
Se
Sp
LR+
LR−
ICU

Article

These are the options to access the full texts of the publication Allergologia et Immunopathologia
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Allergologia et Immunopathologia

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 22,50 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.