Predictive value of the respiratory syncytial virus risk-scoring tool in the term infant in Canada

Paes, Bosco; Cole, M.S.; Latchman, Andrew; Pinelli, Janet

doi:10.1185/03007990903126908

Cited by 12 publications

(10 citation statements)

References 20 publications

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“…Based on national and provincial guidelines, 88% of the admissions to PICU in our study would not have qualified for RSV prophylaxis. Moreover, 66% of all admissions aged ≤2 years were greater than 36 weeks gestation, and currently none of the risk factors in the Canadian risk assessment tool effectively target a sub-group of patients among this cohort that would cost-effectively benefit from prophylaxis [30]. The incidence of RSV infection in those who received palivizumab prophylaxis was 3.3% and is within the range of similar reports from the scientific literature.…”

Section: Comparison Of Young and Older Children With Rsvsupporting

confidence: 69%

The impact of prophylaxis on paediatric intensive care unit admissions for RSV infection: a retrospective, single-centre study

et al. 2010

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Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections and hospitalizations in children aged < 2 years. The aim of this retrospective, single-centre study was to examine the characteristics of patients admitted to a paediatric intensive care unit (PICU) with RSV infection following the implementation of a RSV prophylaxis programme. Electronic hospital medical records of all PICU admissions for RSV infection were searched from 2003 to 2009. Data on baseline demographics, underlying disease, criteria for hospitalization, respiratory diagnosis and management, complications and palivizumab prophylaxis were collected. A total of 181 patients were admitted with RSV infection, accounting for 5.7% of all admissions. Eighty-four percent were ≤ 2 years of age. Majority (70.2%) had no underlying medical illness, and 79.6% received antibiotics as part of their medical treatment. Comparison of children aged ≤ 2 years and those >2 years revealed that fewer of the younger cohort (20.4% versus 79.3%; p < 0.001) had an underlying medical condition. RSV infection occurred in 3.3% (n = 6) children who had received palivizumab prophylaxis, and there were two deaths. The results indicate that > 88% of all PICU admissions would not qualify for RSV prophylaxis under our established guidelines and 66% of the children aged ≤ 2 years were > 36 weeks gestation and are not currently targeted for prophylaxis. The number of high-risk infants admitted to PICU with RSV infection has likely plateaued, and further reductions in admission rates may only be realised with the use of universal, vaccine immunization programmes.

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Section: Comparison Of Young and Older Children With Rsvsupporting

confidence: 69%

The impact of prophylaxis on paediatric intensive care unit admissions for RSV infection: a retrospective, single-centre study

et al. 2010

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“…None of the latter group was hospitalized, but 5/346 low risk group infants were hospitalized. Thus it would appear that the Canadian scoring tool identified most high risk babies for prophylaxis since the overall rate of hospitalization was 5/430 (1.2%) compared to the rate of 66/1758 (3.7%) [65] in the multicenter study of un-prophylaxed Canadian infants. Validation of the European Risk Factor Scoring Tool is being undertaken in Holland and other European countries.…”

Section: Models For Predicting Rsv In the Late Preterm Infantsmentioning

confidence: 99%

Risk Factors for Severe Respiratory Syncytial Virus Lower Respiratory Tract Infection

Sommer

Resch²,

Simões³

2011

TOMICROJ

196

183

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RSV infection is a leading cause of lower respiratory tract infection, especially in High-risk infants with a history of prematurity, bronchopulmonary dysplasia (BPD), congenital heart disease (CHD), neuromusculair impairment, immunodeficiency, and Down syndrome. Host related risk factors that have been identified to be associated with severe RSV related lower respiratory tract infection include young age below 6 months at the beginning of RSV season, multiple birth, male sex, low socioeconomic status and parental education, crowded living conditions, young siblings, maternal smoking and indoor smoke pollution, malnutrition/small for gestational age, family history of atopy or asthma, low cord serum RSV antibody titers, and living at altitude.Risk factors increasing the risk of acquisition of RSV have been identified to be birth before and/or during RSV season, day care attendance, presence of older siblings in school or day-care, and lack of breast feeding. Some of these risk factors are discussed controversially and some of them are found continuously throughout the literature.Given the high cost of RSV prophylaxis, especially for the large population of late preterm infants, algorithms and risk score systems have been published that could identify high-risk infants for treatment with palivizumab out of this gestational age group. Several models reported on an average sensitivity and specificity of 70 percent and, thus, are helpful to identify infants at high risk for severe RSV infection and need for prophylaxis with palivizumab.

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“…As shown in Paes et al [151], the model developed in Sampalis et al [146] cannot accurately predict RSV hospitalization or ED visit for term infants. Also, the predictors of RSV hospitalization that work for preterm infants born at 33-35 weeks gestation have little or no predictive power for term infants.…”

Section: Predicting Rsv Hospitalizationmentioning

confidence: 95%

“…It remains an open problem to develop models to predict the true need for (complicated) seasonal RSV hospitalization for all young children, not only those born at 33-35 weeks gestation [151]. 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].…”

Section: Predicting Rsv Hospitalizationmentioning

confidence: 99%

“…Since each gestational stage has its own set of predictors of RSV hospitalization [151], we should build a separate predictive model for each gestational stage tailored to children born at that stage. Moreover, RSV hospitalization cost varies by several times in infants with different risk factors and different pre-existing medical conditions [139].…”

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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Predictive value of the respiratory syncytial virus risk-scoring tool in the term infant in Canada

Cited by 12 publications

References 20 publications

The impact of prophylaxis on paediatric intensive care unit admissions for RSV infection: a retrospective, single-centre study

The impact of prophylaxis on paediatric intensive care unit admissions for RSV infection: a retrospective, single-centre study

Risk Factors for Severe Respiratory Syncytial Virus Lower Respiratory Tract Infection

A systematic review of predictive modeling for bronchiolitis

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