Wood´s modified scale concordance with management location of patients with acute bronchiolitis
Main Article Content
Abstract
Introduction: Modified Wood's clinical asthma severity scale (M-WCAS), a validated scale in Colombia, is a useful tool to measure severity in acute bronchiolitis. The scale could prevent interobserver variability, and support better patients' management location (ambulatory, hospitalization, intensive care unit). Objective: To estimate the concordance between the severity of acute bronchiolitis measured by M-WCAS, management location, and hospital stay days of patients with acute bronchiolitis in a pediatric referral center. Methods: In a retrospective concordance study, 364 medical records of patients with acute bronchiolitis were reviewed. Researchers calculated the M-WCAS score. Concordance was estimated between the scale score at admission, management location, and hospital stay days of patients who required in-hospital treatment. Results: We found a kappa index of -0.51 between clinical severity by M-WCAS scale and management location. A Lin concordance coefficient of 0.03 between M-WCAS score and hospital stay days. Conclusions: We found no correlation between the clinical severity of bronchiolitis measured by the M-WCAS scale with the patient´s management location. We identified a slight concordance between the M-WCAS score, and hospital stay days.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
You are free to:
Share - copy and redistribute the material in any medium or format.
Adapt - remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
• ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
• No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
References
Piñero FJ, Alfayate MS, Menasalvas RA, et al. Características epidemiológicas, clínicas y terapéuticas de lactantes hospitalizados por bronquiolitis. AnPediatr. 2012; 77(6):391–6.
Ricci V, Delgado Nunes V, Murphy MS, Cunningham S. Bronchiolitis in children: summary of NICE guidance. Bmj. 2015; 350(14): 2305–2305.
Ralston S, Lieberthal A, Meissner H, et al. American Academy of Pediatrics. Clinical Practice Guideline: The Diagnosis,Management, and Prevention of Bronchiolitis. Pediatrics. 2014; 134:1474-1502.
Ministerio de salud y protección social. Guía de práctica clínica del ministerio de salud para la evaluación del riesgo y manejo inicial de la neumonía en niñas y niños menores de 5 años y bronquiolitis en niñas y niños menores de 2 años. 2014; 42:13-56.
Ricart S, Marcos M, Sarda M, Anton A, Muñoz-Almagro C, Pumarola T, et al. Clinical risk factors are more relevant than respiratory viruses inpredicting bronchiolitis severity. Pediatr Pulmonol. 2013; 48(5):456–63.
Riese J, McCulloh RJ, Koehn KL, Alverson BK. Demographic Factors Associated with Bronchiolitis Readmission. Hosp Pediatr. 2014; 4(3):147–52.
Yusuf S, Caviness AC, Adekunle-Ojo AO. Risk Factors for Admission in Children with Bronchiolitis From Pediatric Emergency Department Observation Unit. Pediatr Emerg Care. 2012; 28(11):1132–1135.
Corneli HM, Zorc JJ, Holubkov R, Bregstein JS, Brown KM, Mahajan P, et al. Bronchiolitis: clinical characteristics associated with hospitalization and length of stay. Pediatr Emerg Care. 2012; 28(2): 99–103.
García C, Bhore R, Soriano-Fallas A. Risk Factors for Admission in Children with Bronchiolitis From Pediatric Emergency Department Observation Unit. Pediatrics. 2010; 126(6):1132-1135.
Corneli HM, Zorc JJ, Holubkov R, Bregstein JS, Brown KM, Mahajan P, et al. Bronchiolitis: clinical characteristics associated with hospitalization and length of stay. Pediatr Emerg Care. 2012; 28(2):99–103.
Mallory M, Shay D, Garrett J, Bordley C. Bronchiolitis management preferences and the influence of pulse oximetry and respiratory rate on the decision to admit. Pediatrics. 2003; 111:45–51.
Ramos J, Cordón A, Galindo R, Urda A. Validación de una escala clínica de
severidad de la bronquiolitis aguda. AnPediatr, 2014; 81(1):3-8.
Bekhof J, Reimink P, Brand P. Systematic review: Insufficient validation of clinical scores for the assessment of acute dyspnoea in wheezing children. Pediatric Respiratory Reviews. 2014; 15: 98-112.
Luarte Martinez S, Rodriguez I, Astudillo P, Manterola C. Psychometric properties of scales used for grading the severity of bronchial obstruction in pediatrics: A systematic review and meta-analysis. Arch Argent Pediatr. 2017;115(3):241-248.
Rodriguez C, Sossa M, Nino G. Systematic review of instruments aimed at evaluating the severity of bronchiolitis. Paediatr Respir Rev. 2018; 25:43-57.
Duarte-Dorado DM, Madero-Orostegui DS, Rodriguez-Martinez CE, Nino G. Validation of a scale to assess the severity of bronchiolitis in a population of hospitalized infants. J. Asthma. 2013; 50(10):1056–61.
Carrasco J, Jover L. Métodos estadísticos para evaluar la concordancia. Med Clin. Elsevier; 2004;122(1):28–34.
Cerda J, Villaroel del P. Evaluación de la concordancia inter-observador en investigación pediátrica: Coeficiente de Kappa. Rev Chil Pediatr. 2008; 79 (1): 54-58.
McCallum G, Morris P, Wilson C, Versteegh L, Ward L, Chatfield M, et al. Severity scoring systems: are they internally valid, reliable and predictive of oxygen use in children with acute bronchiolitis? Pediatr Pulmonol. 2013; 48(8):797–803.
Rodríguez D, Rodríguez-Martínez C, Cárdenas A, Quilaguy I, Mayorga L, Falla L, et al. Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region. Pediatr Pulmonol. 2014; 49 (3): 269–76.
Hervás D, Reina J, Yanez A, Del Valle JM, Figuerola J, Hervás J, Epidemiology of hospitalization for acute bronchiolitis in children: Differences between RSV and non-RSV bronchiolitis. Eur J Clin Microbiol Infect Dis. 2012; 31(8):1975–81.
Sala K, Moore A, Desai S, Welch K, Bhandari S, Carroll C. Factors associated with disease severity in children with bronchiolitis. 2015; 52 (3):268-272.