Validation study of an acute bronchiolitis severity scale to determine admission to a Paediatric Intensive Care Unit

Introduction: At present, there are few validated scoring tests for assessing acute bronchiolitis (AB) severity, and limited information on their test power. The aim of the present study is to evaluate the validity of an acute bronchiolitis severity score (ABSS) to help in deciding PICU admission. Patients and method: Prospective, descriptive, observational study of previously healthy infants under 1 year of age with AB, where the ABSS was used to compare severity as regards the need for PICU admission. The sample size was estimated as at least 175 patients. The research team was trained in the use of ABSS. All patients in the study were evaluated with ABSS daily, as well as in the case of clinical deterioration. The initial and maximum ABSS scores were contrasted to the need for PICU admission. A receiver operative curve was constructed, and the area under the curve was calculated, and the optimum point of sensitivity / specificity was estimated. Results: The study included a total of 190 patients (male / female: 58% / 42%). PICU was required in 11 (6%). The mean +/- SD ABSS-maximal score for patients who required and did not require PICU was 10.55 +/- 1.12 and 6.35 +/- 2.3, respectively (P<.001). The AUC for ABSS-maximal was 0.94 (P<.001, 95% CI: 0.90-0.98). The optimal cut-off point was set at >= 10 points for a sensitivity of 82% and a specificity of 91%. Conclusions: ABSS estimates the severity of AB regarding the need for PICU admission, with a sensitivity and specificity of clinical usefulness. (C) 2017 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.