Can you die from bronchiolitis
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Can You Die from Bronchiolitis?
Understanding Bronchiolitis and Its Severity
Bronchiolitis is a common respiratory infection, particularly affecting infants and young children. It is primarily caused by respiratory syncytial virus (RSV) and can lead to severe respiratory distress. While most cases of bronchiolitis are mild and manageable with supportive care, severe cases can lead to hospitalization and, in rare instances, death.
Mortality Rates and Risk Factors
General Mortality Rates
Studies have shown that the mortality rate for bronchiolitis is relatively low. For instance, a systematic review of U.S. infants and children under 5 years old reported that the case fatality ratio (CFR) for all-cause bronchiolitis (ACB) ranged from 0% to 0.17%1. Another study examining bronchiolitis-associated deaths in the U.S. found an average annual infant mortality rate of 2.0 per 100,000 live births5. These figures indicate that while death from bronchiolitis is possible, it is uncommon.
High-Risk Groups
Certain groups are at higher risk of severe outcomes from bronchiolitis. Infants with very low birth weight (VLBW) and low birth weight (LBW) are particularly vulnerable. The mortality rate for VLBW infants was found to be significantly higher compared to those with normal birth weight5. Other risk factors include prematurity, congenital heart disease, and chronic lung conditions6. Additionally, infants admitted to intensive care units (ICUs) and those with public insurance were found to have higher CFRs1.
Bronchiolitis Obliterans Syndrome (BOS) and Mortality
Bronchiolitis obliterans syndrome (BOS) is a severe, chronic form of bronchiolitis that can occur after lung transplantation or hematopoietic stem cell transplantation. BOS is associated with a significant decline in lung function and increased mortality. Studies have shown that a decrease in forced expiratory volume (FEV1) is consistently linked to a higher risk of death in patients with BOS2. Furthermore, respiratory viral infections are identified as distinct risk factors for developing BOS and subsequent mortality4.
Trends in Hospitalization and ICU Use
Over the past two decades, the rates of bronchiolitis hospitalization have remained stable, but ICU admissions have increased significantly. A study in Ontario, Canada, reported that ICU admissions for bronchiolitis rose from 38.1 per 1,000 hospitalizations in 2004-2005 to 87.8 per 1,000 hospitalizations in 2017-20183. Despite the increase in ICU use, the overall mortality rate for bronchiolitis has remained stable at 2.8 per 100,000 person-years3.
Conclusion
While bronchiolitis can be a severe and life-threatening condition, especially in high-risk groups, the overall mortality rate is low. Advances in medical care and supportive treatments have contributed to managing the condition effectively. However, certain populations, such as premature infants and those with underlying health conditions, remain at higher risk and require careful monitoring and intervention. Understanding these risk factors and trends can help healthcare providers better manage and treat bronchiolitis, potentially reducing the risk of fatal outcomes.
Sources and full results
Most relevant research papers on this topic
Mortality Among US Infants and Children Under 5 Years of Age with Respiratory Syncytial Virus and Bronchiolitis: A Systematic Literature Review
RSV mortality rates in US infants and children under 5 years old are variable, and current, nationally representative estimates are needed for otherwise healthy, late-preterm to full-term infants and children.
Systematic ReviewRelationship between FEV1 decline and mortality in patients with bronchiolitis obliterans syndrome-a systematic literature review.
Lower FEV1 levels are associated with increased mortality rates in patients with bronchiolitis obliterans syndrome after lung transplantation or allo-HSCT.
Systematic Review
Rigorous JournalRates in Bronchiolitis Hospitalization, Intensive Care Unit Use, Mortality, and Costs From 2004 to 2018.
From 2004 to 2018, bronchiolitis hospitalization and mortality rates remained stable, but ICU use and costs increased significantly.
Observational Study
Very Rigorous JournalRespiratory viral infections are a distinct risk for bronchiolitis obliterans syndrome and death.
Respiratory viral infections, particularly lower respiratory tract-CARV infections, are distinct risk factors for developing bronchiolitis obliterans syndrome and death after lung transplantation.
Observational Study
Highly CitedRisk factors for bronchiolitis-associated deaths among infants in the United States
VLBW and LBW infants are at increased risk of dying with bronchiolitis, while most bronchiolitis deaths occur among infants of normal birth weight.
Observational StudyHighly CitedBronchiolitis-associated mortality and estimates of respiratory syncytial virus-associated deaths among US children, 1979-1997.
or =510 RSV-associated deaths occurred annually among US children between 1979-1997, fewer than previously estimated.
Observational StudyHighly CitedObliterative bronchiolitis after lung and heart-lung transplantation.
Obliterative bronchiolitis (OB) is a major cause of morbidity and mortality after lung and heart-lung transplantation, with early diagnosis and improved management leading to improved survival rates.
Observational StudyHighly CitedAssociation Between Non-obstructive Chronic Bronchitis and Incident Chronic Obstructive Pulmonary Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis
Individuals with non-obstructive chronic bronchitis (NOCB) have a higher risk of developing COPD and all-cause mortality, emphasizing the need for strategies to screen for and reduce NOCB risk.
Meta-AnalysisBronchiolitis obliterans in chronic graft-versus-host disease: analysis of risk factors and treatment outcomes.
Older recipients and donors, acute GVHD, and diagnosis of Bronchiolitis obliterans 6 months after transplantation are associated with increased risk of developing the condition, which has a high mortality rate of 55% and pulmonary failure as the leading cause of death.
Observational StudyHighly CitedLung ultrasound for prediction of respiratory support in infants with acute bronchiolitis: A cohort study
Lung ultrasound at admission can accurately predict the need for respiratory support in infants with acute bronchiolitis, improving prognosis and reducing hospitalizations.
Observational StudyRigorous Journal