Abstract

GARCIA, Graciela; SCHVARTZMAN, Sergio D.  and  PEREZ, María C.. Factores de riesgo para mala evolución en niños hospitalizados por infección respiratoria baja causada por virus sincicial respiratorio. Arch. argent. pediatr. [online]. 2006, vol.104, n.1, pp.23-29. ISSN 0325-0075.

Objectives. To describe the outcome of previously healthy children hospitalized for acute lower respiratory tract infection (ALRI) caused by respiratory syncycial virus (RSV), and to identify clinical and epidemiologic factors at the admission that could predict a more severe disease. Population, materials and methods. Prospective cohort study. All previously healthy 1-24 month-old children, who were admitted to a tertiary center for ALRI with a positive RSV nasopharingeal aspirate, during a five years period (1995-1999) were included. Data regarding perinatal history, nutritional status, breastfeeding, apneas before hospitalization, chest radiograph and pulse oxymetry in room air (the latter two taken at admission) were collected. Complicated hospitalization was defined as a longer than ten days hospital stay or mechanical ventilation requirement. Results. 318 children were enrolled, their mean age was 5.83 months, and 55.3% were male. Sixteen percent weighed less than 2500 g at birth (LBW), and 9% were malnourished. 72.1% had an oxygen saturation below 90% and 46.8% had pulmonary consolidation on the chest radiograph, 20 patients had recent apnea (6.3%). Fifty two children (16.4%) required mechanical ventilation, 4 of them died (1.25%). Risk factors for longer stay were oxygen saturation lower than 90% and radiologic pulmonary consolidation on admission (in logistic regression analysis). Risk factors for mechanical ventilation included the former two, recent apnea and malnutrition. Short age, lack of breast feeding or LBW did not increase the risk for bad outcome. Conclusions. Oxygen saturation lower than 90%, radiologic consolidation on admission, recent apnea and malnutrition were significant risk factors associated with complicated hospitalization.

Keywords : Respiratory syncytial virus; Respiratory tract infection; Hospitalization; Risk factors.

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