%0 Journal Article
%T Prospective Validation of a Prognostic Model for Respiratory Syncytial Virus Bronchiolitis in Late Preterm Infants: A Multicenter Birth Cohort Study
%A Maarten O. Blanken
%A Hendrik Koffijberg
%A Elisabeth E. Nibbelke
%A Maroeska M. Rovers
%A Louis Bont
%A on behalf of the Dutch RSV Neonatal Network
%J PLOS ONE
%D 2013
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0059161
%X Objectives This study aimed to update and validate a prediction rule for respiratory syncytial virus (RSV) hospitalization in preterm infants 33每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每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每3.2), birth period (OR 2.6; 1.6每4.2), breastfeeding (OR 1.7; 1.0每2.7) and siblings or daycare attendance (OR 4.7; 1.7每13.1). The model showed good discrimination (c-statistic 0.703; 0.64每0.76, 0.702 after bootstrapping). External validation showed good discrimination and calibration (c-statistic 0.678; 0.61每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.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0059161