European risk factors' model to predict hospitalization of premature infants born 33–35 weeks' gestational age with respiratory syncytial virus: validation with Italian data

Abstract

Objectives. A model for predicting respiratory syncytial virus hospitalization in infants born 33–35 weeks' gestational age (wGA) has been developed from the Spanish FLIP study risk factors. The model correctly classified 71% of cases and the area under the receiver operating characteristic (ROC) curve was 0.791. To assess its applicability in Italy, the model was validated against data from the Osservatorio VRS study.

Methods. Discriminant function analysis was used to validate the model by (a) using the predictive variables identified in FLIP to generate a function from the Italian data and (b) applying the coefficients from the FLIP calculations to the Italian data.

Results. The function calculated from the Italian data provided 77% accurate classification (ROC: 0.773). Applying the FLIP coefficients to the Italian data resulted in correctly classifying 68% of cases and a ROC of 0.760. The number needed to treat to prevent hospitalization of 80% of at risk infants was 13.4, based on a hospitalization rate of 5% and 80% treatment efficacy.

Conclusions. The Italian data confirm the predictive ability of the model, which could be used to target palivizumab prophylaxis in Italian infants born 33–35 wGA.

Keywords:

• hospitalization
• premature infants
• 33–35 weeks' gestational age
• respiratory syncytial virus

Acknowledgements

Strategen Limited provided medical writing assistance, which was funded by Abbott Laboratories, Abbott Park, Illinois and Abbott Italy.

European Working Group: Johannes Liese, Pädiatrische Infektiologie und Immunologie, Kinderklinik der Universität, Universität Würzburg, Germany, Xavier Carbonell-Estrany (co-Chair), Neonatology Service, Hospital Clínic, Institut Clínic de Ginecologia Obstetricia i Neonatologia, Neonatology Service, Barcelona, Spain; Eric AF Simões (co-Chair), Department of Pediatrics, Section of Infectious Diseases, The University of Colorado School of Medicine and The Children's Hospital, Denver, Colorado, USA; Ignazio Barberi, Neonatal Intensive Care Unit, Department of Pediatrics, University of Messina, Italy; Angelika Berger, Department of Neonatology and Pediatric Intensive Care, University Children's Hospital, Vienna, Austria; Louis Bont, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands; Jean Bottu, Department of Neonatology of Luxembourg, Luxembourg; Karina Butler, Our Lady's Hospital for Sick Children, Dublin, Ireland; Veerle Cossey, Neonatal Intensive Care Unit, University Hospital Gasthuisberg, Leuven, Belgium; Gunther Doring, Children's Hospital, Technical University, Munich, Germany; Jean-Bernard Gouyon, Department of Pediatrics, CHU, Dijon, France; Bernard Guillois, Laboratory of Human and Molecular Virology, Caen, France; E Farri-Kostopoulou, St Andrew Hospital, Patras, Greece; Marcello Lanari, Pediatrics and Neonatology Unit, Hospital of Imola, Italy; Patrice Morville, Pediatric Cardiology, American Memorial Hospital, Reims, France; Bernhard Resch, Division of Neonatology, Department of Paediatrics, University Hospital Graz, Austria; Kate Sauer, Pediatrics, University Hospital, Leuven, Belgium; Richard Thwaites, Pediatric Department, St Mary's Hospital, Portsmouth, UK.