Risk factors for severe respiratory syncytial virus-associated lower respiratory tract infection in children.
BACKGROUND
Respiratory syncytial virus (RSV) is the most important cause of viral lower respiratory tract infection that can be a life-threatening disease in infants and children. This study was conducted to look for independent risk factors for severe respiratory syncytial virus-associated lower respiratory tract infection (RSV-LRI) that required oxygen supplementation or mechanical ventilation.


METHODS
Medical records of patients younger than 4 years hospitalized with RSV-LRI at Shizuoka Red Cross Hospital from July 1, 1995 to June 30, 1999 were reviewed. The patients were compared using univariate and multivariate logistic regression analysis.


RESULTS
A total of 157 patients were hospitalized with RSV-LRI at Shizuoka Red Cross Hospital from the study time period. Of these, 20 patients (12.7%) were diagnosed with severe RSV-LRI. Subjects younger than 3 months of age had an odds ratio (OR) of 59.9 (95% confidence interval (CI) 14.7_244.0) for the dependent variable of severe RSV-LRI (P<0.0001). Subjects with a history of congenital heart disease also had an OR of 99.2 (95% C1 8.5-1160.1) (P<0.0005).


CONCLUSIONS
Infants younger than 3 months without any underlying diseases may be at high risk for severe RSV-LRI. Respiratory syncytial virus prophylaxis is needed not only for high-risk patients, but for healthy early infants.
Kaneko
M
M
Department of Pediatrics, Shizuoka Red Cross Hospital, Shizuoka, Japan. srcl@tokai.or-jp
Watanabe
J
J
Ueno
E
E
Hida
M
M
Sone
T
T
D000367:Age Factors; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000151:congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D010102:Oxygen Inhalation Therapy; D018357:Respiratory Syncytial Virus Infections / Q000145:classification / Q000453:epidemiology* / Q000628:therapy; D012141:Respiratory Tract Infections / Q000145:classification / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D012720:Severity of Illness Index; D012122:Ventilators, Mechanical