Mortality rate of bronchiolitis
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Bronchiolitis Mortality Rate: Global and Regional Insights
Bronchiolitis Mortality Rate in High-Income Countries
In high-income countries such as the United States and Canada, bronchiolitis mortality rates among infants and young children are low. Large-scale studies in the US report an average annual bronchiolitis-associated infant mortality rate of about 2.0 per 100,000 live births, with most deaths occurring in infants aged 1 to 3 months and those with very low birth weight (VLBW) or other risk factors . A systematic review of US data found that case fatality ratios (CFRs) for all-cause bronchiolitis (ACB) ranged from 0% to 0.17%, and for RSV bronchiolitis from 0% to 1.7%, with higher rates among premature infants and those admitted to intensive care units . Another US study found an overall bronchiolitis mortality rate of 0.14% among hospitalized children, with some regional and racial disparities .
In Canada, a population-based study from 2004 to 2018 found a stable bronchiolitis mortality rate of 2.8 per 100,000 person-years in children under 2 years, despite increases in ICU admissions and hospital costs . Similarly, in Spain, the in-hospital mortality rate for RSV bronchiolitis in children under 1 year ranged from 69 to 120 per 100,000 hospitalizations, with higher risk in children with underlying health conditions .
Bronchiolitis Mortality Rate in Low- and Middle-Income Countries
In contrast, studies from low- and middle-income countries report higher bronchiolitis mortality rates. For example, a study in Cameroon found a mortality rate of 10.7% among hospitalized children under 2 years with acute bronchiolitis, with higher risk in younger patients and those requiring oxygen therapy . This highlights the impact of healthcare access, management practices, and comorbidities on outcomes in different settings.
Risk Factors for Bronchiolitis-Associated Death
Across studies, several risk factors consistently increase the risk of death from bronchiolitis:
- Prematurity and low birth weight (especially VLBW infants) 69
- Presence of congenital heart or lung disease 14
- Young age (especially under 3 months)
- Socioeconomic factors, such as public insurance or lower household income 89
- Regional and racial disparities, with higher mortality observed in certain US regions and among Black infants in the southern US 39
Trends Over Time
Mortality rates from bronchiolitis have generally declined or remained stable in high-income countries over recent decades, even as hospitalization and ICU admission rates have fluctuated 124. Improvements in supportive care and risk factor management have contributed to these trends.
Conclusion
Bronchiolitis mortality rates are low in high-income countries, typically ranging from 0.14% to 2.8 per 100,000 person-years or live births, but can be much higher in low-resource settings. The risk of death is greatest in infants with prematurity, underlying health conditions, or socioeconomic disadvantages. While overall mortality has remained stable or declined in recent years in developed countries, disparities persist, and targeted interventions are needed to further reduce risk in vulnerable populations 1234+4 MORE.
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