CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES OF ACUTE BRONCHIOLITIS IN INFANTS: A PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
acute bronchiolitis, respiratory syncytial virus, infant hospitalization, severity assessment, treatment outcomes
Abstract
Acute bronchiolitis is the leading cause of hospitalization in infants under one year of age, with limited data available from Indian healthcare settings. This study aimed to evaluate clinical characteristics, severity patterns, and treatment outcomes in infants hospitalized with acute bronchiolitis and identify predictors of severe disease.
Methods: A prospective observational study was conducted at Ananta Institute of Medical Sciences & Research Centre, Rajasthan, from January to June 2024. One hundred forty-two infants aged 1-24 months with acute bronchiolitis were enrolled using consecutive sampling. Comprehensive assessment included demographic data, clinical presentation, viral testing, Wang Bronchiolitis Severity Score, treatment interventions, and hospitalization outcomes. Multivariate logistic regression identified independent predictors of severe disease.
Results: Mean age was 6.8±5.2 months with 62.7% males and 40.8% under 3 months. Respiratory syncytial virus was the predominant pathogen (58.7%), significantly associated with severe disease. Mean Wang Bronchiolitis Severity Score was 4.8±2.6, with 23.2% classified as severe cases. Oxygen therapy was required in 69.0% of patients, with 16.9% requiring ICU admission. Mean hospital length of stay was 4.8±3.2 days. Independent predictors of severe disease included age <3 months (OR 4.23, 95% CI 1.78-10.05), prematurity (OR 2.84, 95% CI 1.02-7.91), initial oxygen saturation <90% (OR 8.94, 95% CI 3.01-26.58), and respiratory rate >60/minute (OR 2.76, 95% CI 1.08-7.05).
Conclusion: Young age, prematurity, and initial hypoxemia are strong predictors of severe bronchiolitis. Standardized severity assessment and evidence-based supportive care protocols should be implemented to optimize outcomes and resource utilization in Indian healthcare settings.
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Dr. Anup Paliwal
Associate Professor, Department of Pediatrics, Ananta Institute of Medical Sciences & Research Centre, Rajsamand, Rajasthan