Clinical profile and risk factors in hospitalized children with bronchiolitis

Bronchiolitis, potentially life-threatening respiratory condition is the most common reason for hospitalization in infancy.

The aim of the study was to determine the risk factors and to describe the clinical profile in children who were admitted to the hospital with a diagnosis of bronchiolitis.

Methods: We studied 153 children, the analysis we conducted was restricted to first hospitalizations within the first 18 months. Data from their medical records were entered in a specially designed questionnaire. The following data were analyzed: age on admission, gender, gestational age, association of bronchiolitis with children’s nutritional status. Clinical factors such as chronic lung disease and congenital heart disease (CHD) were investigated. Socioeconomic status, possible exposure to passive smoking, family history of atopy, number of siblings were also investigated. The respiratory rate, oxygen saturation, presence of chest wall retractions and cyanosis upon admission were noted.

Results: Of the 153 patients 85 were males and 68 females, giving a male to female ratio of 1,25:1. Sixty-six percent were under 9 months of age and were previously healthy children. We could not find significant association between bronchiolitis and nutritional status. Shorter or lack of exclusive breastfeeding was a risk factor for the hospitalization. 37% of the children were passive smokers. Socioeconomic status was a factor in increasing the risk of hospital admission in our patients. Prevalence rate for bronchiolitis was higher in rural areas compared to urban ones. Other factors, such as a diagnosis of bronchodysplasia, CHD, and prematurity were not significantly associated with being hospitalized for bronchiolitis. The best method for initial assessment of bronchiolitis was oxygen saturation.

Conclusion: The youngest infants and those who have been exposed to cigarette smoke after birth have the highest risk of bronchiolitis. The association between socioeconomic factors and hospitalization indicates that these factors may have a significant influence on the hospitalization rate in bronchiolitis during infancy. The promoting of exclusive breastfeed­ing is for prevention of infectious diseases and also because of the lesser aggressive course of bronchiolitis in breastfed children.