European Journal of Pediatrics

, Volume 173, Issue 11, pp 1429–1435 | Cite as

Virologic testing in bronchiolitis: does it change management decisions and predict outcomes?

  • Fabiola Stollar
  • Gabriel Alcoba
  • Alain Gervaix
  • Constance Barazzone Argiroffo
Original Article
First Online:
Received:
Revised:
Accepted:

Abstract

The aim of this study was to evaluate the clinical, therapeutic, laboratory, and radiological differences between respiratory syncytial virus (RSV) and non-RSV bronchiolitis in order to assess if the prior knowledge of viral etiology changed management decisions and would be able to predict outcomes. Medical charts of children <1 year admitted to the emergency department with bronchiolitis during two RSV seasons (2010–2012) were reviewed. We analyzed 221 episodes of bronchiolitis. The percentage of exams performed (95 % confidence interval (CI) 0.74–2.52), abnormal laboratory and radiological findings (95 % CI 0.53–16.89) did not differ between groups. RSV bronchiolitis had a more severe clinical course. However, virologic testing for RSV had low specificity in identifying at-risk patients for hospitalization, longer hospital length of stay, and need of oxygen therapy and nasogastric tube (44, 40, 42, and 35 %, respectively), and while statistically significant, the positive likelihood ratios were only slightly greater than 1. Conclusion: Although RSV bronchiolitis has a more severe clinical course, virologic testing does not help in management decisions, and at an individual level, as a performance test, it seems insufficient to precisely predict outcomes.

Keywords

Bronchiolitis Disease severity Outcomes Respiratory syncytial virus Virologic testing 

Abbreviations

CBC

Complete blood count

CI

Confidence interval

CRP

C-reactive protein

ED

Emergency department

hMPV

Human metapneumovirus

ICD

International Classification of Diseases

IQR

Interquartile range

ICU

Intensive care unit

LOS

Hospital length of stay

LR

Likelihood ratio

NGT

Nasogastric tube

OR

Odds ratio

PCR

Polymerase chain reaction

RSV

Respiratory syncytial virus

SD

Standard deviation

SpO2

Pulse oxygen saturation

WBC

White blood cell

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Notes

Acknowledgements

We would like to thank the Platform of Clinical Research of Children’s Hospital, University Hospitals of Geneva, Switzerland.

Funding

The completion of this project did not require background extern.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Fabiola Stollar
    • 1
  • Gabriel Alcoba
    • 2
  • Alain Gervaix
    • 2
  • Constance Barazzone Argiroffo
    • 1
  1. 1.Pediatric Pulmonology Unit, Children’s HospitalUniversity Hospitals of GenevaGeneva 14Switzerland
  2. 2.Pediatric Emergency Division, Children’s HospitalUniversity Hospitals of GenevaGenevaSwitzerland

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