Clinical Profile and Risk Factors for Severity and Mortality in Acute Bronchiolitis in Children Less Than 2 Years of Age Attending an Urban Referral Centre
INTRODUCTION: Acute bronchiolitis, an acute infectious disease of the lower respiratory tract, which primarily affects the smaller airways. It is predominantly a viral respiratory disease. It is one of the leading causes of hospitalisation in infants and young children. It occurs usually between one month to 24 months of age with a peak incidence between 3 and 6 months of age. Each year in the United States, approximately two per 100,000 infants die as a result of complications associated with bronchiolitis1. In young children, the clinical diagnosis of this disease may overlap with viral wheezing and an acute viral triggered asthma. AIM OF THIS STUDY: 1. To describe the clinical profile and 2.To study the risk factors for severity and mortality in infants and young children less than 2 years of age presenting with acute bronchiolitis at an urban referral hospital. DISCUSSION: Bronchiolitis is an acute, infectious disease of the upper and lower respiratory tract resulting in obstruction of the smaller airways. Although it may occur in all age groups, as the larger airways of older children and adults better tolerate mucosal edema and severe symptoms are usually only evident in young infants. It usually occurs in children less than two years of age and presents with coughing, wheezing, and shortness of breath often caused by respiratory syncytial virus.
In our study, we have included 215 children who were diagnosed as bronchiolitis. Out of them, 167(77.67%) children had mild and moderate disease, whereas 48(22.33%) children had severe disease similar to El Radhi A, et al study56. Among those 48 children presented as severe disease, 4 of them died with a mortality rate of 1.86% similar to Thorburn K52 study, with a mortality rate of 1.7% and other studies showing mortality rate ranging from 0.5 to 7%. This wide range in mortality could be due to varying prevalence of pathogenic organisms in different regions of the world.
In our study, 125(58.10%) children were belong to less than 6 months of age which is comparable with Shay DK, et al study in which 57% of cases were less than 6 months of age group54. The mean age group in our study is 4.6 months which is comparable to El-Radhi A, et al study56. Out of 215 children in our study, 63.7% children were males and 36.3% children were females similar to Al-Muhsen SZ, et al study60. Most of these cases (83.3%) were reported between the months of October to January. This seasonal pattern is comparable to Al-Muhsen SZ, et al study60. All children in our study presented with a short duration of upper respiratory illness in the form of cough, cold, sneezing or running nose along with breathing difficulty which similar to other studies51-60. Among the 215 children, fever was documented in 150(69.8%) children in our study, of which 87.3% children had low grade fever, which is comparable to El-Radhi A, et al study56. The duration of hospital stay was ranging from 1- 15 days with a mean hospital stay of 3.52 days, which is similar to El-Radhi A, et al study56, in which the mean duration of hospital stay was 3.3 days, whereas Fjaerli HO, et al study59 showed 4.0 days, as the mean duration of hospital stay. CONCLUSION
