Estudio clinicoepidemiológico de la bronquiolitis aguda
Clinical-epidemiological study of acute bronchiolitis
H. González García
, F.M. García García, J.E. Fernández Alonso
Autor para correspondencia
med010461@nacom.es
Correspondencia: Servicio de Pediatría. Hospital Medina del Campo. Crta. de Peñaranda, s/n. 47400 Medina del Campo. Valladolid
Correspondencia: Servicio de Pediatría. Hospital Medina del Campo. Crta. de Peñaranda, s/n. 47400 Medina del Campo. Valladolid
Servicio de Pediatría. Hospital Medina del Campo. Universidad de Valladolid
a Servicio de Pediatría. Hospital Medina del Campo.Área de Pediatría. Universidad de Valladolid
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Badell Serra, T. Olivé Oliveras, L. Madero López, A. Muñoz Villa, A. Martínez Rubio, A. Verdeguer Miralles, C. Díaz de Heredia Rubio, M.A. Díaz Perez, J. Cubells Rieró, M.S. Maldonado Regalado, J.J. Ortega Aramburu" "autores" => array:12 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Badell Serra" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Olivé Oliveras" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Madero López" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Muñoz Villa" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Martínez Rubio" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Verdeguer Miralles" ] 6 => array:2 [ "nombre" => "C." "apellidos" => "Díaz de Heredia Rubio" ] 7 => array:2 [ "nombre" => "M.A." "apellidos" => "Díaz Perez" ] 8 => array:2 [ "nombre" => "J." "apellidos" => "Cubells Rieró" ] 9 => array:2 [ "nombre" => "M.S." "apellidos" => "Maldonado Regalado" ] 10 => array:2 [ "nombre" => "J.J." 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"apellidos" => "González García" "email" => array:1 [ 0 => "med010461@nacom.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F.M." "apellidos" => "García García" ] 2 => array:2 [ "nombre" => "J.E." "apellidos" => "Fernández Alonso" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Pediatría. Hospital Medina del Campo. Universidad de Valladolid" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Pediatría. Hospital Medina del Campo. Crta. de Peñaranda, s/n. 47400 Medina del Campo. Valladolid" ] ] ] 1 => array:3 [ "autoresLista" => "B. Izquierdo López, A. Pino Vázquez, A. Blanco Quirós" "autores" => array:3 [ 0 => array:3 [ "nombre" => "B." "apellidos" => "Izquierdo López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Pino Vázquez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Blanco Quirós" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Pediatría. Hospital Medina del Campo.Área de Pediatría. Universidad de Valladolid" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical-epidemiological study of acute bronchiolitis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-06-30" "fechaAceptado" => "2000-08-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186517" "palabras" => array:7 [ 0 => "Lactantes" 1 => "Bronquiolitis" 2 => "Virus respiratorio sincitial" 3 => "Sibilancias" 4 => "Hospitalización" 5 => "Infección respiratoria" 6 => "Malformaciones" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186516" "palabras" => array:7 [ 0 => "Infants" 1 => "Bronchiolitis" 2 => "Respiratory syncytial virus" 3 => "Wheezing" 4 => "Hospital admissions" 5 => "Respiratory infections" 6 => "Mal-formations" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Conocer la incidencia de hospitalización por bronquiolitis en nuestro medio, analizar las malformaciones neonatales graves como factor de riesgo de ingreso porbronquiolitis y establecer las variables disponibles en elmomento del ingreso por bronquiolitis que se asocian auna peor evolución.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de incidencia de ingreso por bronquiolitis enpoblación general y en niños con malformaciones neonatales graves. Estudio descriptivo y analítico sobre las características clínicas disponibles en el ingreso por bronquiolitis que predicen una peor evolución, sobre 61 niñosnacidos en el Hospital de Medina del Campo. Todos cumplían los criterios de McConnochie y se clasificaron segúnla evolución en leve, moderado o grave.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La incidencia acumulada anual de ingreso por bronquiolitis fue de 1,79 % (intervalo de confianza [IC] del 95 %,1,–2,30). La incidencia de hospitalización fue significativamente mayor en los niños con antecedentes de malformaciones neonatales graves (13,11 %) que en los sanos(1,59 %) (RR, 8,26; IC 95 %, 4,–16,02). La edad fue significativamente menor (p=0,0056) en el grupo grave (mediana, 1,0; cuartiles, 1,–2,75) que en los grupos moderado(mediana, 5,0; cuartiles, 2,–8,0) y leve (mediana, 5,5; cuar-tiles, 3,–9,0). Tomando como referencia la evolución levese relacionaron con una evolución moderada-grave el rechazo de tomas (OR, 4,08; IC 95 %, 1,–16,80), los vómitos (OR, 4,22; IC 95 %, 1,–25,30) y la espiración alargada(OR, 5,35; IC 95 %, 1,–24,30). Tomando como referenciael grupo levemoderado se relacionaron con evolucióngrave la presencia de vómitos (p=0,004), los crepitantes(p=0,002), la disminución de ventilación (p<0,001) y la condensación radiológica (p=0,017).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La incidencia de ingreso por bronquiolitis se situó encifras similares a las de otros países. Las variables que presentes en el momento del ingreso se asociaron a una peorevolución fueron: edad inferior a 3 meses, vómitos, rechazo de tomas, espiración alargada, crepitantes, disminuciónde ventilación y condensación radiológica. Las malformaciones neonatales graves son un importante factor de riesgo para requerir ingreso por bronquiolitis.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the incidence of hospital admissions forbronchiolitis in our environment, to analyze the importance of neonatal malformations as a risk factor for hospitalization for bronchiolitis and to establish the variables available on admission that are associated with aworse evolution.</p> <span class="elsevierStyleSectionTitle">Design and patiens</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Descriptive study of admissions for bronchiolitis in asample of the general population and in children with severe neonatal malformations. Descriptive and analyticalstudy of the clinical characteristics available on admissionfor bronchiolitis that predict a worse evolution. Sixtyonechildren born at the Medina del Campo Hospital in Spainwere studied. All the children were diagnosed according to McConnochie's criteria and classified into three groupsaccording to evolution (mild, moderate and severe).</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The annual cumulative incidence of admissions due tobronchiolitis was 1.79 % (95 % CI, –2.30). This incidence was higher in children with a history of severe neonatalmalformations (13.11 %) than in those without malformations (1.59 %) (RR58.26; CI 95 %, –16.02). Childrenwith severe bronchiolitis were younger (p50.0056; median 1.0, quartiles –2.75) than those with moderatebronchiolitis (median 5.0; quartiles –8.0) or mild bronchiolitis (median 5.5; quartiles –9.0). Using the groupwith mild bronchiolitis as reference, diminished appetite(OR54.08; 95 % CI, –16.80), vomiting (OR54.22; 95 %CI, –25.30) and prolonged expiration (OR55.35, 95 %CI, –24.30) were associated with moderate-severe evolution. Using the mildmoderate group as reference, vomiting (p50.004), crepitant rales (p50.002), decreasedventilation (p,0.001) and radiological consolidations(p50.017) were associated with severe evolution.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The incidence of hospital admission for bronchiolitis inour environment was similar to data reported from othercountries. Variables available at admission predicting aworse evolution were age lower than 3 months, vomiting,diminished appetite, prolonged expiration, crepitant rales,decreased ventilation and radiological consolidations. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 11 | 17 | 28 |
| 2024 Octubre | 101 | 59 | 160 |
| 2024 Septiembre | 74 | 43 | 117 |
| 2024 Agosto | 97 | 93 | 190 |
| 2024 Julio | 73 | 54 | 127 |
| 2024 Junio | 96 | 26 | 122 |
| 2024 Mayo | 90 | 44 | 134 |
| 2024 Abril | 76 | 42 | 118 |
| 2024 Marzo | 63 | 42 | 105 |
| 2024 Febrero | 47 | 35 | 82 |
| 2024 Enero | 53 | 28 | 81 |
| 2023 Diciembre | 83 | 31 | 114 |
| 2023 Noviembre | 78 | 24 | 102 |
| 2023 Octubre | 61 | 40 | 101 |
| 2023 Septiembre | 49 | 26 | 75 |
| 2023 Agosto | 23 | 22 | 45 |
| 2023 Julio | 39 | 37 | 76 |
| 2023 Junio | 45 | 29 | 74 |
| 2023 Mayo | 43 | 19 | 62 |
| 2023 Abril | 43 | 23 | 66 |
| 2023 Marzo | 35 | 28 | 63 |
| 2023 Febrero | 38 | 28 | 66 |
| 2023 Enero | 29 | 19 | 48 |
| 2022 Diciembre | 44 | 19 | 63 |
| 2022 Noviembre | 65 | 40 | 105 |
| 2022 Octubre | 50 | 45 | 95 |
| 2022 Septiembre | 38 | 23 | 61 |
| 2022 Agosto | 40 | 49 | 89 |
| 2022 Julio | 35 | 49 | 84 |
| 2022 Junio | 27 | 36 | 63 |
| 2022 Mayo | 40 | 37 | 77 |
| 2022 Abril | 44 | 41 | 85 |
| 2022 Marzo | 46 | 51 | 97 |
| 2022 Febrero | 51 | 58 | 109 |
| 2022 Enero | 33 | 40 | 73 |
| 2021 Diciembre | 22 | 38 | 60 |
| 2021 Noviembre | 44 | 47 | 91 |
| 2021 Octubre | 45 | 45 | 90 |
| 2021 Septiembre | 49 | 47 | 96 |
| 2021 Agosto | 46 | 43 | 89 |
| 2021 Julio | 35 | 42 | 77 |
| 2021 Junio | 51 | 43 | 94 |
| 2021 Mayo | 79 | 35 | 114 |
| 2021 Abril | 82 | 100 | 182 |
| 2021 Marzo | 115 | 24 | 139 |
| 2021 Febrero | 94 | 53 | 147 |
| 2021 Enero | 51 | 39 | 90 |
| 2020 Diciembre | 60 | 19 | 79 |
| 2020 Noviembre | 17 | 11 | 28 |
| 2020 Octubre | 41 | 17 | 58 |
| 2020 Septiembre | 38 | 14 | 52 |
| 2020 Agosto | 23 | 11 | 34 |
| 2020 Julio | 49 | 18 | 67 |
| 2020 Junio | 41 | 25 | 66 |
| 2020 Mayo | 52 | 28 | 80 |
| 2020 Abril | 61 | 17 | 78 |
| 2020 Marzo | 42 | 10 | 52 |
| 2020 Febrero | 49 | 17 | 66 |
| 2020 Enero | 48 | 11 | 59 |
| 2019 Diciembre | 51 | 25 | 76 |
| 2019 Noviembre | 32 | 17 | 49 |
| 2019 Octubre | 25 | 6 | 31 |
| 2019 Septiembre | 45 | 21 | 66 |
| 2019 Agosto | 65 | 24 | 89 |
| 2019 Julio | 43 | 37 | 80 |
| 2019 Junio | 45 | 46 | 91 |
| 2019 Mayo | 116 | 50 | 166 |
| 2019 Abril | 56 | 24 | 80 |
| 2019 Marzo | 32 | 13 | 45 |
| 2019 Febrero | 37 | 27 | 64 |
| 2019 Enero | 42 | 16 | 58 |
| 2018 Diciembre | 45 | 30 | 75 |
| 2018 Noviembre | 63 | 19 | 82 |
| 2018 Octubre | 73 | 14 | 87 |
| 2018 Septiembre | 44 | 10 | 54 |
| 2018 Julio | 1 | 0 | 1 |
| 2018 Junio | 2 | 0 | 2 |
| 2018 Mayo | 5 | 0 | 5 |
| 2018 Abril | 34 | 0 | 34 |
| 2018 Marzo | 12 | 0 | 12 |
| 2018 Febrero | 10 | 0 | 10 |
| 2018 Enero | 12 | 0 | 12 |
| 2017 Diciembre | 18 | 0 | 18 |
| 2017 Noviembre | 16 | 0 | 16 |
| 2017 Octubre | 18 | 0 | 18 |
| 2017 Septiembre | 17 | 0 | 17 |
| 2017 Agosto | 21 | 0 | 21 |
| 2017 Julio | 18 | 1 | 19 |
| 2017 Junio | 28 | 15 | 43 |
| 2017 Mayo | 29 | 15 | 44 |
| 2017 Abril | 22 | 4 | 26 |
| 2017 Marzo | 19 | 10 | 29 |
| 2017 Febrero | 9 | 10 | 19 |
| 2017 Enero | 16 | 7 | 23 |
| 2016 Diciembre | 51 | 17 | 68 |
| 2016 Noviembre | 79 | 11 | 90 |
| 2016 Octubre | 105 | 10 | 115 |
| 2016 Septiembre | 52 | 9 | 61 |
| 2016 Agosto | 43 | 8 | 51 |
| 2016 Julio | 26 | 9 | 35 |
| 2016 Junio | 1 | 0 | 1 |
| 2016 Abril | 2 | 0 | 2 |
| 2016 Febrero | 1 | 0 | 1 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Noviembre | 2 | 0 | 2 |
| 2015 Julio | 10 | 0 | 10 |
| 2015 Junio | 11 | 0 | 11 |
| 2015 Mayo | 13 | 0 | 13 |
| 2015 Abril | 9 | 0 | 9 |
| 2015 Marzo | 18 | 0 | 18 |
| 2015 Febrero | 15 | 0 | 15 |
| 2015 Enero | 9 | 0 | 9 |
| 2014 Diciembre | 13 | 0 | 13 |
| 2014 Noviembre | 3 | 0 | 3 |
| 2014 Octubre | 13 | 0 | 13 |
| 2014 Septiembre | 9 | 4 | 13 |
| 2014 Agosto | 7 | 1 | 8 |
| 2014 Julio | 10 | 2 | 12 |
| 2014 Junio | 12 | 1 | 13 |
| 2014 Mayo | 14 | 1 | 15 |
| 2014 Abril | 11 | 2 | 13 |
| 2014 Marzo | 12 | 6 | 18 |
| 2014 Febrero | 6 | 2 | 8 |
| 2014 Enero | 14 | 7 | 21 |
| 2013 Diciembre | 19 | 11 | 30 |
| 2013 Noviembre | 11 | 7 | 18 |
| 2013 Octubre | 18 | 6 | 24 |
| 2013 Septiembre | 11 | 7 | 18 |
| 2013 Agosto | 6 | 5 | 11 |
| 2013 Julio | 3 | 3 | 6 |
| 2013 Junio | 3 | 4 | 7 |
| 2013 Mayo | 4 | 2 | 6 |
| 2013 Abril | 2 | 2 | 4 |
| 2013 Marzo | 7 | 4 | 11 |
| 2013 Febrero | 13 | 3 | 16 |
| 2013 Enero | 11 | 1 | 12 |
| 2012 Diciembre | 11 | 1 | 12 |
| 2012 Noviembre | 11 | 3 | 14 |
| 2012 Septiembre | 0 | 1 | 1 |
| 2000 Diciembre | 809 | 0 | 809 |
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