Risk factors assessment and treatment methods in infants with severe bronchiolitis

Introduction: Bronchiolitis, a viral infection of the lower respiratory tract, is one of the most substantial health burdens for infants and young children worldwide. Despite the respiratory syncytial virus (RSV) being the most common causative agent of bronchiolitis, there is a number of established risk factors associated with development of severe bronchiolitis. The aim of this study was to investigate the prevalence of established risk factors for severe bronchiolitis among hospitalized infants during the first year of life, as well as to compare the diagnostic and treatment methods between pulmology and neonatology department. Material and methods: This epidemiological, case-controlled, retrospective-prospective study included all children aged one year or younger who were diagnosed with severe bronchiolitis and hospitalized in Pediatric Clinic of Clinical Center University of Sarajevo from 1 May 2017 to 30 April 2018 (12 months). Patient data was collected from the patients’ histories and through interviews with parents and filled in the previously designed questionnaire. Results: The research included 95 hospitalized infants diagnosed with bronchiolitis who were less than 12 months old. Sample size was homogenized by gender (p>0.05). Patients were predominantly term children younger than 6 months at the time of the hospitalization. Admission rate was highest during the first four mounts of the year (71.6%) with peak in March (23.3%). The findings show that significant risk factors are presence of viral disease in the family, smoking during pregnancy and smoking in the household. Most of the patients (87.3%) received antibiotic or corticosteroid treatment during hospitalization, with a significant difference in antibiotic and corticosteroid use between pulmology and neonatology department (p<0.05). Conclusion: Infants with comorbidities and negative gestational and socioeconomic factors more often develop severe form of bronchiolitis during the first year of life.