Follow-up of the prognosis of recurrent wheezing in early childhood and the risk factors of continued wheezing
HU Xiaoguang, YU Hongmei, WU Qiuping, LIN Li, ZHANG Hailin, LI Changchong.
Department of Pediatric Respiratory Disease, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027
HU Xiaoguang,YU Hongmei,WU Qiuping, et al. Follow-up of the prognosis of recurrent wheezing in early childhood and the risk factors of continued wheezing[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(5): 365-368.
Abstract：Objective: To investigate the prognosis of recurrent wheezing in children in their first 3 years of life and the risk factors of continued wheezing at school age; to determine the predict power of pediatric asthma predict index, and finally provide useful information for the prevention and treatment of asthma in childhood. Methods: Eligible patient: Children with “recurrent wheezing” less than 3 years of age who hospitalized in our hospital from January 1, 2009 to December 31, 2009. Basic data of enrolled patients were collected from our hospital’s digital medical record database. After then, we conducted prospective telephone interviews and clinical follow-up for 4 years after their hospital discharges to investigate their persistence of wheezing and present condition. Results: Totally 1 011 cases were screened, and 106 eligible patients were finally followed up. There were 30 (28%) of them still with episodes of wheezing for 4 years after their discharges from hospital. And 44.2% (23/52) of patients with positive modified asthma predict index (mAPI) had wheezing, which was significant higher than the 13% (7/54) in patients with negative mAPI (x²=13.26, P<0.01; OR 5.33, OR 95%CI: 2.03~13.97). The sensitivity of mAPI for prediction of continued wheezing was 76.7% (23/30), and specificity was 61.8% (47/76). According to univariate analysis, male (x²=5.26, P<0.05), physician diagnosed eczema (x²=8.17, P<0.01), food allergy (x²=7.25, P<0.01), no-infection induced wheezing (x²=22.95, P<0.01), and parent’s history of allergic rhinitis (x²=22.83, P<0.01) were correlated to continued wheezing. Subsequent multivariate logistic regress analysis revealed that physician diagnosed eczema, no-infection induced wheezing and family history of allergic rhinitis were the independent risk factors of continued wheezing. Conclusion: In our country, a positive mAPI score before 3 years may associated with 40% chance of continued wheezing at school age or even less; physician diagnosed eczema, non-infection induced wheezing, and family history of allergic rhinitis may be the important independent risk factors.
