Freire et al developed a model for predicting the use of escalated care in an infant with bronchiolitis. The authors are from multiple institutions from around the world participating in the Pediatric Emergency Research Networks (PERN)
Patient selection: infant with bronchiolitis
Outcome: escalated care (hospitalization with high-flow nasal cannula, noninvasive or invasive ventilation, intensive care admission)
Parameters:
(1) age in months
(2) poor feeding
(3) oxygen saturation in percent
(4) apnea
(5) nasal flaring and/or grunting
(6) dehydration
(7) retractions
Parameter
Finding
Points
age in months
<= 2 months
1
> 2 months
0
poor feeding
no
0
yes
1
oxygen saturation
>= 90%
0
< 90%
5
apnea
no
0
yes
2
nasal flaring and/or grunting
no
0
yes
2
dehydration
no
0
yes
1
retractions
no
0
yes
2
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• The higher the score the greater the use of escalated care.
Score
Percent with Escalated Care
0
0.9%
1
1.5%
2
2.7%
3
5%
4
8%
5
13%
6
21%
7
32%
8
46%
9
60%
10
73%
11
82%
12
89%
13
94%
14
96%
Performance:
• The area under the ROC curve is 0.85.
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