Liu et al reported a nomogram for identifying a child with respiratory syncytial virus (RSV) infection who will develop severe bronchiolitis. A child with severe bronchiolitis requires more aggressive management. The authors are from Tianjin University Children's Hospital and Tianjin Medical University.
Patient selection: age < 2 years, respiratory syncytial virus (RSV) respiratory infection
Parameters:
(1) weight on admission in kilograms, from 2 to 17
(2) preterm birth
(3) percentage of lymphocytes in peripheral blood, from 0 to 90
(4) breathing rate in breaths per minute, from 20 to 60
(5) outpatient use of glucocorticoids
points for weight on admission =
= 110.07 - (6.47 * (weight))
points for percentage lymphocytes =
= MAX(0,65.86 - (0.732 * (percent)))
points for breathing rate =
= (2.5 * (rate)) - 50
|
Parameter
|
Finding
|
Points
|
|
preterm birth
|
no
|
0
|
|
|
yes
|
30.46
|
|
outpatient steroids
|
no
|
0
|
|
|
yes
|
20.69
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 314.13
value of X =
= (0.04451 * (score)) - 6.145
risk of severe bronchiolitis =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.78 in the training and 0.83 in the validation cohorts.
