Clinical–Ultrasound Model to Predict the Clinical Course in Bronchiolitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Lung Ultrasound
2.2. Statistical Analysis
3. Results
3.1. Sample Description
3.2. Ultrasound Findings
3.2.1. LUCS Relation with Outcome Variables
3.2.2. Accuracy of LUCS
3.2.3. Logistic Regression Models
- Hospital Admission: LUCS reached significant values within the 8Z and 6Z models (p = 0.029 and p = 0.045, respectively). The AUCs of the models were 0.899 and 0.889, and the explanatory power (R2) was 47% (Table S6). A score > 3 in the LUCS 8Z would increase the risk of requiring hospital admission by more than 5 times. The 4Z option did not yield significant results (Table 2).
- Oxygen Therapy: Significant values were obtained for the score in all its versions (p = 0.001 for 8Z and 6Z, and p = 0.021 for 4Z) with AUC > 0.85 and R2 up to 55% exploring 6 zones (Table S6). In the LUCS 8Z, a score >6 would increase the risk of requiring oxygen by almost 7 times, and more than 2 points in the LUCS 4Z would increase it by 4 times (Table 2).
- PICU Admission: The LUCS score did not reach a significant value in any extension (8Z, 6Z, or 4Z) (Table 2).
3.2.4. Linear Regression Models
- Hospital Stay: LUCS was significant within the 8 and 6 zone models (p = 0.001). A LUCS score > 3 or 2 (depending on whether it is 8Z or 6Z) would increase the hospital stay by almost 2 days, with an R2 for both models around 45%. The 4Z model did not reach statistical significance (p = 0.082).
- Oxygen Therapy Duration: Significant results were obtained only with the 8Z option (p < 0.001), although the results with 6 zones were close to reaching significance (p = 0.051).
- PICU Stay: No statistical significance was reached for the models in 8Z, 6Z, or 4Z.
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patients’ Characteristics | Patients Outcome | |||
---|---|---|---|---|
Age (m) | 3.68 (1.80–6.65) | Discharged home | 13 (14.4) | |
Weight (kg) | 5.80 (4.71–7.70) | Hospital admission | 77 (85.6) | |
Gestational age (w + d) | 39 + 1 (37 + 5–40 + 2) | Hospital stay (d) | 4 (2–6) | |
Birth weight (g) | 3.080 (2.735–3.455) | PICU admission | 15 (16.6) | |
Gender | Male | 49 (54.43) | PICU stay (d) | 4 (3–5.5) |
Female | 41 (45.6) | Oxygen therapy (low flow/with NIV) | 43 (47.8) | |
Prematurity (<37 weeks) | 8 (8.9%) | Low-flow oxygen therapy only | 30 (69.8) | |
Breastfeeding | 58 (64.4) | Duration of oxygen therapy (d) | 3 (1.5–5) | |
Daycare attendance | 13 (14.4) | Need of NIV | 13 (14.4) | |
Previous episodes of respiratory distress | 22 (24.4) | Duration of NIV support (d) | 2.5 (2–3) | |
Need of IMV | 0 (0) | |||
Household members with respiratory symptoms | 70 (77.8) | |||
Nasopharyngeal Swab | ||||
Not collected | 10 (11.1) | RSV | 54 (67.5) | |
Collected | 80 (88.9) | Adenovirus | 5 (6.25) | |
Negative | 13 (16.25) | Influenza virus | 4 (5) | |
Coinfection | 10 (12.5) | Others | 4 (5) |
Cutoff Point | OR Univariate | OR Multivariate | |||
---|---|---|---|---|---|
Hospitalization | Model 8Z variables | Age (m) | >3.47 | 0.07 (0.00–0.36) p = 0.011 | 0.05 (0.00–0.32) p = 0.008 |
BROSJOD | >6 | 7.33 (1.81–49.50) p = 0.013 | 12.71 (2.60–101.04) p = 0.005 | ||
LUCS 8Z | >3 | 6.41 (1.87–25.86) p = 0.005 | 5.47 (1.28–28.60) p = 0.029 | ||
Model 6Z variables | Age (m) | >3.47 | 0.07 (0.00–0.36) p = 0.011 | 0.06 (0.00–0.36) p = 0.011 | |
BROSJOD | >6 | 7.33 (1.81–49.50) p = 0.013 | 10.85 (2.27–82.31) p = 0.007 | ||
LUCS 6Z | >2 | 9.10 (2.24–61.57) p = 0.006 | 5.90 (1.20–45.00) p = 0.045 | ||
Model 4Z variables | Age (m) | >3.47 | 0.07 (0.00–0.36) p = 0.011 | 0.07 (0.00–0.42) p = 0.016 | |
BROSJOD | >6 | 7.33 (1.81–49.50) p = 0.013 | 11.07 (2.40–81.80) p = 0.005 | ||
LUCS 4Z | >2 | 11.10 (2.04–207.16) p = 0.024 | 6.01 (0.88–121.47) p = 0.116 | ||
Oxygen Therapy | Model 8Z variables | Age (m) | >4.07 | 0.44 (0.19–1.01) p = 0.057 | 0.23 (0.06–0.73) p = 0.018 |
BROSJOD | >6 | 11.02 (4.28–31.04) p < 0.001 | 15.77 (5.01–60.80) p < 0.001 | ||
LUCS 8Z | >6 | 6.39 (2.60–16.86) p < 0.001 | 6.88 (2.28–23.61) p = 0.001 | ||
Model 6Z variables | Age (m) | >4.07 | 0.44 (0.19–1.01) p = 0.057 | 0.35 (0.09–1.14) p = 0.093 | |
BROSJOD | >6 | 11.02 (4.28–31.04) p < 0.001 | 16.98 (5.29–67.49) p < 0.001 | ||
LUCS 6Z | >1 | 16.56 (4.37–109.05) p < 0.001 | 17.45 (3.67–134.55) p = 0.001 | ||
Model 4Z variables | Age (m) | >4.07 | 0.44 (0.19–1.01) p = 0.057 | 0.36 (0.10–1.11) p = 0.086 | |
BROSJOD | >6 | 11.02 (4.28–31.04) p < 0.001 | 17.22 (5.66–64.96) p < 0.001 | ||
LUCS 4Z | >2 | 3.63 (1.53–8.98) p = 0.004 | 3.97 (1.29–13.91) p = 0.021 | ||
Picu Admission | Model 8Z variables | Age (m) | >3.37 | 0.10 (0.02–0.41) p = 0.004 | 0.03 (0.00–0.22) p = 0.005 |
BROSJOD | >8 | 38.86 (9.83–205.02) p < 0.001 | 94.99 (13.22–2086.29) p < 0.001 | ||
LUCS 8Z | >8 | 5.84 (1.80–22.86) p = 0.005 | 3.23 (0.52–26.56) p = 0.220 | ||
Model 6Z variables | Age (m) | >3.37 | 0.10 (0.02–0.41) p = 0.004 | 0.03 (0.00–0.28) p = 0.008 | |
BROSJOD | >8 | 38.86 (9.83–205.02) p < 0.001 | 101.08 (14.33–2197.85) p < 0.001 | ||
LUCS 6Z | >3 | 6.00 (1.73–27.98) p = 0.009 | 2.95 (0.46–26.36) p = 0.273 | ||
Model 4Z variables | Age (m) | >3.37 | 0.10 (0.02–0.41) p = 0.004 | 0.03 (0.00–0.26) p = 0.007 | |
BROSJOD | >8 | 38.86 (9.83–205.02) p < 0.001 | 114.50 (16.64–2453.94) p < 0.001 | ||
LUCS 4Z | >2 | 2.38 (0.78–7.77) p = 0.134 | 1.27 (0.19–9.29) p = 0.803 |
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Rodríguez García, L.; Hierro Delgado, E.; Oulego Erroz, I.; Rey Galán, C.; Mayordomo Colunga, J. Clinical–Ultrasound Model to Predict the Clinical Course in Bronchiolitis. Children 2024, 11, 987. https://doi.org/10.3390/children11080987
Rodríguez García L, Hierro Delgado E, Oulego Erroz I, Rey Galán C, Mayordomo Colunga J. Clinical–Ultrasound Model to Predict the Clinical Course in Bronchiolitis. Children. 2024; 11(8):987. https://doi.org/10.3390/children11080987
Chicago/Turabian StyleRodríguez García, Lucía, Elena Hierro Delgado, Ignacio Oulego Erroz, Corsino Rey Galán, and Juan Mayordomo Colunga. 2024. "Clinical–Ultrasound Model to Predict the Clinical Course in Bronchiolitis" Children 11, no. 8: 987. https://doi.org/10.3390/children11080987