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Multicenter Study
. 2013;8(3):e59161.
doi: 10.1371/journal.pone.0059161. Epub 2013 Mar 12.

Prospective validation of a prognostic model for respiratory syncytial virus bronchiolitis in late preterm infants: a multicenter birth cohort study

Maarten O Blanken  1 , Hendrik Koffijberg, Elisabeth E Nibbelke, Maroeska M Rovers, Louis Bont; Dutch RSV Neonatal Network
Collaborators, Affiliations
Multicenter Study

Prospective validation of a prognostic model for respiratory syncytial virus bronchiolitis in late preterm infants: a multicenter birth cohort study

Maarten O Blanken et al. PLoS One. 2013.

Abstract

Objectives: This study aimed to update and validate a prediction rule for respiratory syncytial virus (RSV) hospitalization in preterm infants 33-35 weeks gestational age (WGA).

Study design: The RISK study consisted of 2 multicenter prospective birth cohorts in 41 hospitals. Risk factors were assessed at birth among healthy preterm infants 33-35 WGA. All hospitalizations for respiratory tract infection were screened for proven RSV infection by immunofluorescence or polymerase chain reaction. Multivariate logistic regression analysis was used to update an existing prediction model in the derivation cohort (n = 1,227). In the validation cohort (n = 1,194), predicted versus actual RSV hospitalization rates were compared to determine validity of the model.

Results: RSV hospitalization risk in both cohorts was comparable (5.7% versus 4.9%). In the derivation cohort, a prediction rule to determine probability of RSV hospitalization was developed using 4 predictors: family atopy (OR 1.9; 95%CI, 1.1-3.2), birth period (OR 2.6; 1.6-4.2), breastfeeding (OR 1.7; 1.0-2.7) and siblings or daycare attendance (OR 4.7; 1.7-13.1). The model showed good discrimination (c-statistic 0.703; 0.64-0.76, 0.702 after bootstrapping). External validation showed good discrimination and calibration (c-statistic 0.678; 0.61-0.74).

Conclusions: Our prospectively validated prediction rule identifies infants at increased RSV hospitalization risk, who may benefit from targeted preventive interventions. This prediction rule can facilitate country-specific, cost-effective use of RSV prophylaxis in late preterm infants.

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Conflict of interest statement

Competing Interests: This investigator driven study was funded by Abbott. Dr. Bont has received fees for lectures and advisory activities from Abbott International; the other authors indicated they have no financial relationships relevant to this article to disclose. The authors hereby state they have no Abbott employment or consultancy to declare and no patents, products in development or marketed products related to Abbott to disclose. The authors confirm that this does not alter their adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Patient flowchart derivation and validation cohort.
See this image and copyright information in PMC

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