Key result
Infants aged 6-12 months with bronchiolitis show ~55% lower IV fluid need versus those 0-6 months.
Why the study?
There is no agreement on the upper age limit for bronchiolitis diagnosis, prompting investigation into clinical differences between infants aged 0-6 months and 6-12 months.
Are there clinical differences in infants hospitalized for bronchiolitis between 0-6 months and 6-12 months of age?
Cohort (n=824)
No
Are there clinical differences in infants hospitalized for bronchiolitis between 0-6 months and 6-12 months of age?
Odds Ratio: 0.45 (95% CI 0.2–0.99)
Absolute Event Rate: 29.4% vs 55.1%
p-value: p=0.0001
Infants aged 0-6 months hospitalized for bronchiolitis have a more severe clinical presentation and higher rates of RSV infection compared to those aged 6-12 months, supporting a narrower age definition for the disease.
Younger infants with bronchiolitis may need closer hydration monitoring; leaves open whether age-stratified protocols improve outcomes.
Aim: The most frequent cause of lower respiratory tract infection in infants is bronchiolitis. Up to now there is no agreement on the upper limit age of bronchiolitis. Our aim was to identify if there are clinical differences in infants hospitalized for bronchiolitis between 0-6 months and 6-12 months of age. A secondary aim was to establish whether there was differences in terms of recurrent wheezing at 12, 24 and 36 months of follow-up. Methods: We retrospectively analysed clinical and virological records of 824 infants hospitalised for bronchiolitis during 11 consecutive epidemic seasons. From each infant at admission to the hospital nasopharyngeal washing was collected, clinical severity was assessed and clinical data were extracted from a structured questionnaire. At 12-24-36 months after discharge, parents were interviewed seeking information on recurrent wheezing. Results: A total of 773 infants (Group1) were ≤6 months of age, while 51 were >6 months (Group 2). No differences between family history for atopy and passive smoking exposure were observed between the two groups. Respiratory syncyzial virus was detected more frequently in Group 1 and human bocavirus in Group 2. The clinical severity score (p=0.011) andthe use of intravenous fluids (p=0.0001) were higher in Group 1 with respect to Group 2 infants. At 36 months follow-up 163/106 (39.4%) Group 1 and 9/9 Group 2 infants experienced recurrent wheezing (p=0.149). Conclusion: we demonstrated that 0-6 months old infants bronchiolitis differs from > 6 months bronchiolitis.
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Nenna et al. (2020) conducted a cohort in Bronchiolitis (n=824). Age 6-12 months vs. Age 0-6 months was evaluated on Need for intravenous fluids (OR 0.45, 95% CI 0.20-0.99, p=0.0001). Infants aged 6 to 12 months hospitalized for bronchiolitis had a significantly lower need for intravenous fluids compared to infants aged 0 to 6 months (OR 0.45).
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