Respiratory diseases always account for a significant proportion of visits to the pediatrician or family doctor, and bronchitis is usually a frequent clinical manifestation of acute respiratory diseases. The doctor often faces the question of how to objectively assess the clinical picture of bronchitis, and now the assessment of respiratory symptoms is often based on criteria such as cough, shortness of breath or wheezing on auscultation. However, today there are practically no data on the severity of bronchitis in children depending on the above criteria.
A cohort of 158 children with bronchitis was created at the pulmonology and allergology Department of the Municipal Medical Institution "Regional Children's Clinical Hospital" in Chernivtsi. The severity of bronchitis was assessed at the beginning and on the 3rd and 7th day of inpatient using the Bronchitis Severity Score (BSS). According to this scale, mild bronchitis was verified in 30 patients which formed the I clinical group, and 128 children had moderate bronchitis (II clinical comparison group).
Aggressive inflammation of the bronchi in children with moderate inflammation of the bronchial tree compared with patients with mild bronchitis was accompanied 1.6 times more often by recurrence, a history of episodes of community-acquired pneumonia in 9.4% of patients, long-term inpatient treatment (odds ratio 2.6) and halving the duration of the outpatient treatment period. The study of clinical severity of bronchitis in children of the comparison groups made it possible to establish an increase in the chances of a more severe course of the disease on the 7th day of hospitalization in children with moderate bronchitis (odds ratio 4.8) with persistence of cough in 68.7% of children in this group (odds ratio 3.8). Evaluation of inpatient treatment tactics indicated the need to increase the volume of complex therapy in patients with moderate bronchitis relative to children with mild disease (odds ratio 12.0, relative risk 8.8), as well as increasing the risk of the need for antibacterial therapy (odds ratio 3.7, relative risk 2.8) and the appointment of intravenous antibiotics for more than 3 days (odds ratio 5.0, relative risk 1.1).
CLINICAL FEATURES OF THE COURSE AND ASSESSMENT OF TREATMENT STRATEGY IN CHILDREN WITH BRONCHITIS