Comparison of Pulse Oximetry versus Wang Score in Children Aged Three to Twenty-Four Months Admitted with Acute Bronchiolitis in Pak-Emirates Military Hospital, Rawalpindi

Objective: To determine the diagnostic accuracy of the Wang score and pulse oximetry in detecting patients with severe acute Bronchiolitis. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi, Pakistan from Feb to Aug 2022. Methodology: Seventy-five patients aged between three and twenty-four months, of both genders, with acute Bronchiolitis were included in the study. Those with cystic fibrosis, bronchial asthma, and congenital heart disease were excluded. Patients were assessed for the severity of Bronchiolitis based on a respiratory rate >40 or >35 breaths per minute in a less than one-year-old and a two-year-old, respectively, with a capillary pCO2 of >41.8 mmHg. All patients underwent pulse oximetry, and an SpO2 of <94% was considered indicative of severe disease, while a score of ≥4 on the Wang scoring was considered indicative of severe disease. Results: Our study sample had a mean age of 11.88±5.78 months, the majority of whom were male, i.e., 41(54.7%). Wang score at a cut-off of level of ≥4 as a predictor for the presence of severe acute Bronchiolitis in children had a sensitivity of 68.18%, a specificity of 62.26% and a diagnostic accuracy of 64.00%, while SpO2 measured using finger pulse oximetry had a sensitivity of 88.68%, a specificity of 73.91% and a superior diagnostic accuracy of 85.33% for the same. Conclusion: The Wang score by itself is insufficient to determine whether severe acute Bronchiolitis is present, and requires employment in combination with other modalities ..