The modified respiratory index score (RIS) guides resource allocation in acute bronchiolitis

Chong, Shu-Ling; Teoh, Oon Hoe; Nadkarni, Nivedita; Yeo, Joo Guan; Lwin, Zaw; Ong, Yong-Kwang Gene; Lee, Jan Hau

doi:10.1002/ppul.23663

Cited by 11 publications

(10 citation statements)

References 34 publications

(59 reference statements)

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“…In contrast, there was no statistical difference in the modified RIS score in patients who were hospitalized compared to those discharged. This could be due to the small subset study population and the milder severity with a lower modified RIS as compared to the main cohort . This observation highlights the potential superiority and utility of nasal HMGB1 as a potential predictor for resource utilization for bronchiolitis as compared to modified RIS alone.…”

Section: Discussionmentioning

confidence: 92%

“…This was part of a larger study that focused on a clinical prediction score for bronchiolitis . We recruited a convenience sample of patients that attended the ED during office hours (8am‐6pm) on weekdays.…”

Section: Methodsmentioning

confidence: 99%

“…We collected vital signs at triage including the temperature, oxygen saturations, respiratory rate, and heart rate. We documented the physical findings and the modified respiratory index score (RIS) (Table ). The physician responsible for clinical scoring using the modified RIS and who made the decision for hospitalization was blinded to the results of the caspase and HMGB1 results.…”

Section: Methodsmentioning

confidence: 99%

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Nasal high‐mobility group box 1 and caspase in bronchiolitis

Chong

Lai

Castillo

et al. 2018

Pediatric Pulmonology

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Objective Nasal biomarkers have potential to add objectivity to the clinical assessment of the child with bronchiolitis. We aim to study, if nasal caspase and high‐mobility group box 1 protein (HMGB1) levels differ between patients who were hospitalized and those discharged from the emergency department (ED), among patients with bronchiolitis. Methods Using an observational cross‐sectional study design, we recruited patients younger than 24 months presenting to the ED from September 1, 2015 to May 31, 2017 with a diagnosis of acute bronchiolitis. We described the patients’ clinical severity measured by the modified respiratory index score (RIS), and performed standardized collection and analysis of nasal caspase and HMGB1 levels. Results Among 85 patients recruited, the median age was 5.0 months (interquartile range, IQR 3.3‐7.2) and the median modified RIS score was 3 (IQR 2‐4). Hospitalized patients had a 2.4‐fold higher HMGB1 level than patients who were discharged from the ED (2.558 μg/mL [IQR 1.038‐5.125] vs 1.056 μg/mL [IQR 0.409‐2.395], P = 0.0013). There was no difference in median caspase level between hospitalized and discharged patients. The Area Under the Receiver Operating Characteristics curve predicting hospitalization was 0.7021 for HMGB1 compared to 0.5709 for RIS in this bronchiolitis cohort. Conclusions Our study findings show that nasal HMGB1 levels significantly differentiate between young children with bronchiolitis who were hospitalized compared to those fit for discharge. This exploratory study holds potential for future research on nasal HMGB1 for severity stratification in young children with acute bronchiolitis.

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Section: Discussionmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Nasal high‐mobility group box 1 and caspase in bronchiolitis

Chong

Lai

Castillo

et al. 2018

Pediatric Pulmonology

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“…Another scoring system, the modified Respiratory Index Score (RIS), was found to be a reasonable predictor of the need for hospital admission in a singlecenter study in Singapore. 54 A large multicenter clinical trial did not show any benefit of nebulized hypertonic saline for reduction of hospital admissions in acute bronchiolitics in an emergency department setting. 55 In a review, Hancock et al 56 A randomized, double blind placebo controlled multicenter trial carried out in Spain found that dexamethasone (0.25 mg/kg/dose every 6 h, for 48 h) shortened the duration of illness due to parapneumonic effusion, when coupled with antibiotics.…”

Section: Respiratory Syncytial Virus (Rsv) Infection In Infants and Ymentioning

confidence: 94%

“…Balaguer et al found the clinical severity score known as Bronchiolitis Score of Sant Joan de Déu (BROSJOD) to be a reliable indicator of disease severity for acute bronchiolitis between independent observers. Another scoring system, the modified Respiratory Index Score (RIS), was found to be a reasonable predictor of the need for hospital admission in a single‐center study in Singapore . A large multicenter clinical trial did not show any benefit of nebulized hypertonic saline for reduction of hospital admissions in acute bronchiolitics in an emergency department setting .…”

Section: Introductionmentioning

confidence: 96%

Pediatric Pulmonology year in review 2017: Part 3

Ren

Muston

Yılmaz

et al. 2018

Pediatric Pulmonology

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Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Word count: 71 3

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