Utility of the Global Respiratory Severity Score for predicting the need for respiratory support in infants with respiratory syncytial virus infection

Jun Kubota; Daishi Hirano; Shiro Okabe; Kento Yamauchi; Rena Kimura; Haruka Numata; Takayuki Suzuki; Daisuke Kakegawa; Akira Ito

doi:10.1371/journal.pone.0253532

Utility of the Global Respiratory Severity Score for predicting the need for respiratory support in infants with respiratory syncytial virus infection

PLoS One. 2021 Jul 1;16(7):e0253532. doi: 10.1371/journal.pone.0253532. eCollection 2021.

Authors

Jun Kubota^{1

2}, Daishi Hirano², Shiro Okabe^{1

2}, Kento Yamauchi^{1

2}, Rena Kimura^{1

2}, Haruka Numata^{1

2}, Takayuki Suzuki^{1

2}, Daisuke Kakegawa^{1

2}, Akira Ito^{1

2}

Affiliations

¹ Department of Pediatrics, Atsugi City Hospital, Kanagawa, Japan.
² Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan.

Abstract

Background: Respiratory syncytial virus (RSV) is a common cause of acute respiratory infection in children. One of the most important strategies for treatment of an RSV infection is to decide whether the patient needs respiratory support. This study aimed to assess the validity and clinical benefit of the Global Respiratory Severity Score (GRSS) and the Wang bronchiolitis severity score (WBSS) for clinical decision-making regarding providing respiratory support (high-flow nasal cannula, nasal continuous positive airway pressure, or ventilator) in infants with an RSV infection.

Study design and methods: This retrospective cohort study enrolled 250 infants aged under 10 months who were admitted to Atsugi City Hospital with an RSV infection between January 2012 and December 2019. The utility of these scores was evaluated for assessing the need for respiratory support through decision curve analysis by calculating the optimal GRSS and WBSS cut-offs for predicting the need for respiratory support.

Results: Twenty-six infants (10.4%) received respiratory support. The optimal cut-offs for the GRSS and the WBSS were 4.52 and 7, respectively. Decision curve analysis suggested that the GRSS was a better predictive tool than the WBSS if the probability of needing respiratory support was 10-40%.

Conclusions: The GRSS was clinically useful in determining the need for respiratory support in infants aged under 10 months with an RSV infection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cannula
Female
Humans
Infant
Infant, Newborn
Male
Oxygen / therapeutic use*
Respiration, Artificial / methods*
Respiratory Syncytial Virus Infections / therapy*
Respiratory Syncytial Virus, Human / pathogenicity
Respiratory Tract Infections / therapy*
Retrospective Studies
Severity of Illness Index*

Substances

Oxygen

Grants and funding

This study was supported by Kawano Masanori Memorial Public Interest Incorporated Foundation for Promotion of Paediatrics (31-waka-16) to Jun Kubota. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.