Changes in Care in Spanish Pediatric Emergency Departments After the First Immunization With Nirsevimab.
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Vazquez-Lopez Paula, Rivas-Garcia Aristides, Luaces-Cubells Carles, Perez-Gonzalez Elena, Ales-Palmer María Luisa, Cahis-Vela Nuria, Lera-Carballo Esther, Solano-Navarro Carmen, Romero-Castillo Estefanía, Torres-Begara Eva Patricia, Sanchez-Alvarez Maria Jesus, Benito-Fernandez Javier, Sanz-Rueda Laura, Garcia-Herrero María Angeles, Henares-Rodriguez Alba, Yañez-Mesia Sandra, de Francisco-Profumo Antonio, Martinez-Mejias Abel, May-Llanas Maria Elena, Mesa-Garcia Sofia, Aranda-Mora Alejandro, Baquero-Gomez Concepcion, de la Rosa-Sanchez Daniel, de Ceano-Vivas Maria, de la Torre Espí Mercedes, Oliva-Rodriguez-Pastor Silvia, Guerra-Diez Jo Se Lorenzo, Pons-Morales Sara, Gomez-Carabaza Arantxa, Campos-Calleja Carmen, Torres-Torres Antonio Ramon
Аннотация
METHODS: An observational, retrospective, multicenter study was conducted, analyzing the Bronchiolitis Registry of the Spanish Society of Pediatric Emergency Medicine. This registry, containing data on bronchiolitis cases, was initiated in December 2022. A total of 30 hospitals participated, all of which are members of the Spanish Society of Pediatric Emergency Medicine. Data from a 26-day period in 2 bronchiolitis seasons (2022: preimmunization and 2023: postimmunization) were included. Variables regarding health care burden were recorded for both periods. Quantitative variables were described using mean and SD, and the Student t test was used for comparisons between the 2 periods.
RESULTS: Twenty-five hospitals from 11 autonomous communities were included with a mean of 47,811 PED visits/year (SD: 26,675). The number of bronchiolitis cases presenting to the PED and bronchiolitis-related admissions decreased by 41.6%(95% CI: 34.9%-48.2%) and 55.4% (95% CI: 46.6%-64.2%), respectively, while admissions for RSV bronchiolitis decreased by 60.3% (95% CI: 51.9%-68.7%). Admissions to pediatric intensive care units decreased by 81.3% (95% CI: 57.9%-100%). Furthermore, the occupancy rate in the pediatric intensive care units decreased by 30% (95% CI: 22.8%-37.3%), while a reduction of 22.4% (95% CI: 13.2%-31.5%) was observed in the occupancy rate of observation units. The number of bronchiolitis cases transferred to other hospitals decreased by 73.4% (95% CI: 29.0%-100%). Finally, there was a 60.9% (95% CI: 26.5%-95.3%) reduction in the need for high-flow oxygen therapy among bronchiolitis patients.
CONCLUSIONS: After the introduction of nirsevimab, a large portion of indicators related to the burden of care associated with bronchiolitis during its epidemic season decreased significantly.