Description

Holman et al studied infants who died from viral bronchiolitis in the United States to identify potential risk factors. These can help identify patients who may benefit from more aggressive management. The authors are from the Centers for Disease Control and Prevention.


 

Risk factors associated with infant death:

(1) birth weight < 2,500 grams (odds ratio 13.9 if < 1,500 grams; 3.0 if 1,500 - 2,499)

(2) Apgar score at 5 minutes <= 7 (odds ratio 4.5)

(3) live birth order = older siblings (odds ratio about 2 for 1 or 2 older siblings; 6.3 for 4 or more)

(4) mother's age < 25 years of age (odds ratio 3.7 to 4.4 if < 20; 2.5 if 20 - 24)

(5) mother's education <= 11 years (odds ratio 1.9)

(6) mother unmarried

(7) tobacco use during pregnancy (odds ratio 1.6)

 

where:

• The risk factors correlate with lower socioeconomic status, problems with health coverage, and more crowded living conditions.

• I would think a mother who smoked during pregnancy is probably smoking around the children.

 

For the implementation I made a quick score, with 1 point if the odds ratio was 1.6 to 2.5, 2 points if 2.6 to 4.5, 3 points if 6.3 and 6 points if 13.9. This approach needs to be validated.

 


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