This article is more than 5 years old. Information may no longer be current.
Scoring tool predicts infants at low risk for RSV hospitalization
Click Here to Manage Email Alerts
Receiver operator characteristic analysis failed to discern high from moderate risk for respiratory syncytial virus-associated hospitalization in infants, yet it predicted those at low risk and could be used to inform families about preventing and anticipating the virus, according to study findings.
“In most jurisdictions this passive prophylaxis is not considered cost-effective for routine use and is recommended only for those considered at highest risk of severe RSV associated illness, such as those born at less than or at 29 weeks’ gestation,” Venessa M.J. Ryan, MSc, from the department of community health and epidemiology at Dalhousie University, Halifax, Nova Scotia, and colleagues wrote.
The researchers sought to construct a scoring tool that would determine if infants at 32 to 35 weeks and 6 days’ gestational age (wGA) could be identified as being at a higher risk for RSV-H on the basis of risk factors present at birth. They conducted a retrospective study on a cohort of infants (n = 2,811) pooled from population-based databases in Nova Scotia over a 10-year period. Infants were aged between the prenatal stage and less than 12 months, and infants with lung or cardiac diseases, and those taking palivizumab were excluded.
A logistic regression model was used to measure potential risk factors, and the researchers used receiver operator characteristic analysis to show cut-off scores with the highest predictive accuracy. A likelihood ratio measured the select variables for the predictive tool.
Eighty-eighty infants among the cohort were admitted to the hospital with RSV (3.1%). Seventeen variables, including birth in the winter, household smoke exposure and household crowding, were used to create the scoring tool. The associated likelihood ratio of predictive tool scores for high, moderate and low RSV-H were calculated at 3.57, 3.38 and 1.95, respectively. Post-test analysis for risk of RSV-H was 11.4%, 10.8% and 1.6%, respectively.
“While palivizumab is clearly effective in reducing the risk of RSV-H … there is not unity of thought in the pediatric community on this recommendation,” the researchers wrote. “Nonetheless, a diagnostically accurate and useful tool to predict RSV-H in 32 to 35 wGA infants could theoretically have practical clinical value.
“We propose that this risk factor scoring tool could be used to provide anticipatory guidance to families with children born in the months previous to or during the local RSV season.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts