Med Bull Sisli Etfal Hosp. 2024; 58(1): 102-108 | DOI: 10.14744/SEMB.2023.95605

Evaluation of the Clinical, Laboratory and Radiology Findings and Treatment Methods of Children with Acute Bronchiolitis: Experience of a Tertiary Center

Cuneyt Ugur¹, Elif Somuncu², Taha Demirci^3
1Department of Pediatrics, University of Health Sciences Türkiye, Konya City Health Application and Research Center, Konya, Türkiye
²Department of Pediatrics, Van Training and Research Hospital, Van, Türkiye
³Department of Pediatrics, Turkeli State Hospital, Sinop, Türkiye

Objectives: The aim of this study is to determine the factors affecting the duration of hospitalization and causing the initiation of antibiotics in children with acute bronchiolitis.
Methods: This study was conducted retrospectively in Konya Training and Research Hospital. Demographic data, clinical features, laboratory and radiological findings, treatment methods and duration of hospitalization of 102 patients followed up in the pediatric service between September 2017 and April 2019 (in autumn, winter and spring seasons) were recorded from patient files. Results: 67 (65.7%) of 102 patients were male, and 35 (34.3%) were female. Median age was 6.5 (11.0) months. According to Wang bronchiolitis clinical scoring, 36 (35.3%) of the patients were mild, 51 (50.0%) were moderate, 15 (14.7%) were severe bronchiolitis The most common agents in polymerase chain reaction (PCR) were respiratory syncytial virus 60 (58.8%), influenza virus 20 (19.6%), rhinovirus 15 (14.7%), bocavirus 15 (14.7%) and parainfluenza virus 12 (11.7%). The median duration of hospitalization was 7.0 (4.0) days. Forty-two (41.2%) of the patients were hospitalized for ≤5 days, and 60 (58.8%) were hospitalized for >5 days. Duration of hospitalization was significantly and positively correlated with crepitant crackles, leukocytosis, neutrophilia, and coinfection with influenza virus (p=0.036, p=0.034, p=0.028, p=0.036, respectively). Duration of hospitalization was significantly and negatively correlated with pH and increased aeration (p=0.002, p=0.003, respectively) Antibiotic initiation was significantly and positively correlated with wheezing, crepitant crackles, leukocytosis, and neutrophilia (p=0.033, p=0.013, p=0.028, p=0.002, respectively). Conclusion: A significant relationship was found between crepitant crackles in physical examination, respiratory acidosis in laboratory, co-infection with influenza virus detected by PCR and hospitalization for more than 5 days. A significant relationship was determined between wheezing or crepitant crackles in physical examination, leukocytosis or neutrophilia in laboratory and the initiation of antibiotic.

Keywords: Antibiotic, bronchiolitis, children, hospitalization, respiratory syncytial virus

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Akut Bronþiolitli Çocuklarýn Klinik, Laboratuvar ve Radyolojik Bulgularý ile Tedavi Yöntemlerinin Deðerlendirilmesi: Üçüncü Basamak Merkez Deneyimi

Cuneyt Ugur¹, Elif Somuncu², Taha Demirci^3
1Türkiye Saðlýk Bilimleri Üniversitesi, Konya Ýl Saðlýk Uygulama ve Araþtýrma Merkezi, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Konya
²Van Eðitim ve Araþtýrma Hastanesi, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Van
³Türkeli Devlet Hastanesi, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Sinop

Amaç: Bu çalýþmanýn amacý akut bronþiolitli çocuklarda hastanede yatýþ süresini etkileyen ve antibiyotik baþlanmasýna neden olan faktörleri belirlemektir.
Yöntemler: Bu çalýþma Konya Eðitim ve Araþtýrma Hastanesi'nde retrospektif olarak yapýlmýþtýr. Eylül 2017-Nisan 2019 tarihleri arasýnda (sonbahar, kýþ ve ilkbahar mevsimlerinde) çocuk servisinde izlenen 102 hastanýn demografik verileri, klinik özellikleri, laboratuvar ve radyolojik bulgularý, tedavi yöntemleri ve hastanede yatýþ süreleri hasta dosyalarýndan kaydedildi.
Bulgular: Toplam 102 hastanýn 67'si (%65.7) erkek, 35'i (%34.3) kadýndý. Ortanca yaþ 6.5 (11.0) aydý. Wang bronþiyolit klinik skorlamasýna göre hastalarýn 36'sý (%35.3) hafif, 51'i (%50.0) orta, 15'i (%14.7) þiddetli bronþiolit olarak saptandý. Polimeraz zincir reaksiyonunda (PCR) en sýk etken respiratuvar sinsityal virüs 60 ( %58.8), influenza virüs 20 (%19.6), rinovirüs 15 (%14.7), bocavirüs 15 (%14.7) ve parainfluenza virüs 12 (%11.7). Ortanca hastanede kalýþ süresi 7.0 (4.0) gündü. Hastalarýn 42'si (%41,2) ≤ 5 gün, 60'ý (%58,8) 5 günden fazla hastanede yattý. Hastanede kalýþ süresi, krepitan ral, lökositoz, nötrofili ve influenza virüsle koenfeksiyon ile anlamlý ve pozitif korelasyon gösterdi (sýrasýyla p=0,036, p=0,034, p=0,028, p=0,036). Hastanede kalýþ süresi, pH ve artmýþ havalanma ile anlamlý ve negatif korelasyon gösterdi (sýrasýyla p=0,002, p=0,003). Antibiyotik baþlanmasý, hýþýltýlý solunum, krepitan ral, lökositoz ve nötrofili ile anlamlý ve pozitif korelasyon gösterdi (sýrasýyla p=0,033, p=0,013, p=0,028, p=0,002)
Sonuç: Fizik muayenede krepitan ral, laboratuvarda respiratuar asidoz, PCR ile saptanan influenza virüsle koenfeksiyon ile 5 günden fazla hastanede yatýþ süresi arasýnda anlamlý iliþki bulundu. Fizik muayenede wheezing veya krepitan ral, laboratuvarda lökositoz veya nötrofili ile antibiyotik baþlanmasý arasýnda anlamlý iliþki saptandý. (SETB-2023-08-144)

Anahtar Kelimeler: Antibiyotik, bronþiolit, çocuklar, hastaneye yatýþ, respiratuvar sinsityal virüs

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