Ramos-Fernández, José MiguelMoreno-Pérez, DavidGutiérrez-Bedmar, MarioHernández-Yuste, AlexandraCordón-Martínez, Ana MaríaMilano-Manso, GuillermoUrda-Cardona, Antonio2017-05-262017-05-262017-01-19Ramos-Fernández JM, Moreno-Pérez D, Gutiérrez-Bedmar M, Hernández-Yuste A, Cordón-Martínez AM, Milano-Manso G, et al. Predicción de la evolución de la bronquiolitis por virus respiratorio sincitial en lactantes menores de 6 meses. Rev Esp Salud Pública. 2017; 91; 2017010061135-5727http://hdl.handle.net/10668/2661La necesidad de ventilación mecánica (VM) en la bronquiolitis aguda por el virus respiratorio sincitial (VRS) varía según las series entre el 6 y el 18 %. Nuestro objetivo fue conocer los ingresos en la unidad de cuidados intensivos para VM de pacientes con bronquiolitis aguda menores de 6 meses y definir los factores de riesgo con el fin de construir un modelo de predicción. Método. Estudio retrospectivo de pacientes menores de 6 meses ingresados por bronquiolitis aguda por VRS entre los periodos 1 de abril de 2010 y 31 de marzo de 2015. La variable principal fue el ingreso en la unidad de cuidados intensivos pediátricos para ventilación mecánica. Además, se recogieron variables clínicas relacionadas para hallar factores de riesgo en un modelo de regresión logística binaria. Con el modelo se elaboró una curva ROC y se identificó un punto óptimo de corte. Resultados. De 695 casos, precisaron VM en unidad pediátrica de cuidados intensivos 56 (8,1%). Los factores de riesgo) incluidos en la ecuación fueron: 1. Sexo varón (OR: 4,27) 2. Edad postmenstrual (OR:0,76) 3. Peso al ingreso 37 semanas OR (0,32). El área bajo la curva, sensibilidad y especificidad fueron 0,943; 0,84 y 0,93 respectivamente. Conclusiones. Los ingresos en UCIP para VM fueron 8,1 por cada 100 lactantes sanos hospitalizados por BA y año. La ecuación elaborada del modelo de predicción puede ser de ayuda para predecir los pacientes con mayor riesgo de evolución grave.Background. The need for mechanical ventilation (MV) in acute bronchiolitis (AB) by respiratory syncytial virus (RSV) varies depending on the series (6-18%). Our goal is to determine the admissions to PICU for MV in patients under 6 months with AB and define the risk factors for building a prediction model. Methods. Retrospective study of patients younger than 6 months admitted by BA-VRS between the periods April 1, 2010 and March 31, 2015 was made. The primary variable was the admission to PICU for MV. Related addition, to find risk factors in a model of binary logistic regression clinical variables were collected. A ROC curve model was developed and optimal cutoff point was identified. Results. In 695 cases, the need of MV in the PICU was 56 (8.1%). Risk factors included in the equation were: 1. male sex (OR 4.27) 2. postmenstrual age (OR: 0.76) 3. Weight income 37 weeks OR (0.32). The area under the curve, sensitivity and specificity were 0.943, 0.84 and 0.93 respectively. Conclusions. The PICU admission for MV was 8.1 in every 100 healthy infants hospitalized for AB and year. The prediction model equation can help to predict patients at increased risk of severe evolution.esIncidenceBronchiolitisIntensive care unitsPediatricMechanical ventilationLogistic modelRespiratory syncytial virusesIncidenciaBronquilitisUnidad de cuidados intensivos pediatricosVentilacion mecánicaModelo de regresion logisticaVRSEspañaMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Acute DiseaseMedical Subject Headings::Diseases::Respiratory Tract Diseases::Bronchial Diseases::Bronchitis::BronchiolitisMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control StudiesMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Patient Care::HospitalizationMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Persons::Persons::Age Groups::InfantMedical Subject Headings::Persons::Persons::Age Groups::Infant::Infant, NewbornMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Units::Intensive Care Units::Intensive Care Units, PediatricMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic ModelsMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Mononegavirales Infections::Paramyxoviridae Infections::Pneumovirus Infections::Respiratory Syncytial Virus InfectionsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective StudiesMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Causality::Risk FactorsMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::SpainMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Decision Support TechniquesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Respiratory Therapy::Respiration, ArtificialMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Data Collection::Health Surveys::Health Status Indicators::Patient Acuity::Severity of Illness Indexresearch article28104904open access2173-9110