Cargando…

The analysis of risk factors for recurrent wheezing in infants and clinical intervention

BACKGROUND: Asthma is one of the most common chronic diseases affecting children’s health, and recurrent wheezing in infants is closely related to childhood asthma. However, up to now, there is a lack of unified diagnostic criteria and interventions for recurrent wheezing in infants. By analyzing an...

Descripción completa

Detalles Bibliográficos
Autores principales: Geng, Liting, Tang, Xiaoyu, Hua, Li, Liu, Haipei, Ren, Shaolong, Zhong, Wenwei, Zhang, Jianhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644017/
https://www.ncbi.nlm.nih.gov/pubmed/37969130
http://dx.doi.org/10.21037/tp-23-45
_version_ 1785147190654533632
author Geng, Liting
Tang, Xiaoyu
Hua, Li
Liu, Haipei
Ren, Shaolong
Zhong, Wenwei
Zhang, Jianhua
author_facet Geng, Liting
Tang, Xiaoyu
Hua, Li
Liu, Haipei
Ren, Shaolong
Zhong, Wenwei
Zhang, Jianhua
author_sort Geng, Liting
collection PubMed
description BACKGROUND: Asthma is one of the most common chronic diseases affecting children’s health, and recurrent wheezing in infants is closely related to childhood asthma. However, up to now, there is a lack of unified diagnostic criteria and interventions for recurrent wheezing in infants. By analyzing and discussing the risk factors of recurrent wheezing in infants and related intervention measures, we aim to take individualized treatment for different children and reduce the occurrence of recurrent wheezing in infants. METHODS: From January 2017 to December 2020, children under 3 years old who were admitted to the Department of Pediatric Respiratory of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine with the chief complaint of wheezing for the first time and were clinically diagnosed with bronchiolitis, asthmatic bronchopneumonia and asthmatic bronchitis were retrospectively analyzed through telephone questionnaires. These children were divided into two groups based on whether the wheezing occurred again after discharge. The demographic characteristics, clinical treatment, imaging characteristics, and related interventions and outcomes after discharge were analyzed in both groups. RESULTS: Among the 523 children under 3 years old who were hospitalized due to wheezing, 264 (50.5%) did not have wheezing after discharge, and 259 (49.5%) still had wheezing after discharge. Both chi-squared test and multivariate analysis showed that male, history of eczema, history of rhinitis, history of wheezing before hospitalization, family smoke exposure, mycoplasma infection and inhalation allergen sensitization were risk factors for recurrent wheezing in infants and young children (P<0.05). Simultaneously, Cox survival curve showed that different intervention time and intervention methods would lead to different prognosis. CONCLUSIONS: (I) Male, with a history of eczema, rhinitis, wheezing before hospitalization, family environment smoke exposure, mycoplasma infection and a history of inhalation allergy are high risk factors for recurrent wheezing in the recurrent wheezing group, and are more likely to have recurrent wheezing after discharge, with shorter days of wheezing control; (II) there was a significant interaction between mycoplasma infection and a history of inhalation allergy in infants with the risk of recurrent wheezing; (III) long-term intervention for children with wheezing for 4 weeks or more after discharge can reduce the probability of recurrent wheezing; (IV) for children of male, with a history of eczema or rhinitis, the most effective intervention to reduce the probability of recurrent wheezing is long-term inhaled corticosteroids (ICS) treatment after discharge.
format Online
Article
Text
id pubmed-10644017
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-106440172023-11-15 The analysis of risk factors for recurrent wheezing in infants and clinical intervention Geng, Liting Tang, Xiaoyu Hua, Li Liu, Haipei Ren, Shaolong Zhong, Wenwei Zhang, Jianhua Transl Pediatr Original Article BACKGROUND: Asthma is one of the most common chronic diseases affecting children’s health, and recurrent wheezing in infants is closely related to childhood asthma. However, up to now, there is a lack of unified diagnostic criteria and interventions for recurrent wheezing in infants. By analyzing and discussing the risk factors of recurrent wheezing in infants and related intervention measures, we aim to take individualized treatment for different children and reduce the occurrence of recurrent wheezing in infants. METHODS: From January 2017 to December 2020, children under 3 years old who were admitted to the Department of Pediatric Respiratory of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine with the chief complaint of wheezing for the first time and were clinically diagnosed with bronchiolitis, asthmatic bronchopneumonia and asthmatic bronchitis were retrospectively analyzed through telephone questionnaires. These children were divided into two groups based on whether the wheezing occurred again after discharge. The demographic characteristics, clinical treatment, imaging characteristics, and related interventions and outcomes after discharge were analyzed in both groups. RESULTS: Among the 523 children under 3 years old who were hospitalized due to wheezing, 264 (50.5%) did not have wheezing after discharge, and 259 (49.5%) still had wheezing after discharge. Both chi-squared test and multivariate analysis showed that male, history of eczema, history of rhinitis, history of wheezing before hospitalization, family smoke exposure, mycoplasma infection and inhalation allergen sensitization were risk factors for recurrent wheezing in infants and young children (P<0.05). Simultaneously, Cox survival curve showed that different intervention time and intervention methods would lead to different prognosis. CONCLUSIONS: (I) Male, with a history of eczema, rhinitis, wheezing before hospitalization, family environment smoke exposure, mycoplasma infection and a history of inhalation allergy are high risk factors for recurrent wheezing in the recurrent wheezing group, and are more likely to have recurrent wheezing after discharge, with shorter days of wheezing control; (II) there was a significant interaction between mycoplasma infection and a history of inhalation allergy in infants with the risk of recurrent wheezing; (III) long-term intervention for children with wheezing for 4 weeks or more after discharge can reduce the probability of recurrent wheezing; (IV) for children of male, with a history of eczema or rhinitis, the most effective intervention to reduce the probability of recurrent wheezing is long-term inhaled corticosteroids (ICS) treatment after discharge. AME Publishing Company 2023-10-24 2023-10-30 /pmc/articles/PMC10644017/ /pubmed/37969130 http://dx.doi.org/10.21037/tp-23-45 Text en 2023 Translational Pediatrics. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Geng, Liting
Tang, Xiaoyu
Hua, Li
Liu, Haipei
Ren, Shaolong
Zhong, Wenwei
Zhang, Jianhua
The analysis of risk factors for recurrent wheezing in infants and clinical intervention
title The analysis of risk factors for recurrent wheezing in infants and clinical intervention
title_full The analysis of risk factors for recurrent wheezing in infants and clinical intervention
title_fullStr The analysis of risk factors for recurrent wheezing in infants and clinical intervention
title_full_unstemmed The analysis of risk factors for recurrent wheezing in infants and clinical intervention
title_short The analysis of risk factors for recurrent wheezing in infants and clinical intervention
title_sort analysis of risk factors for recurrent wheezing in infants and clinical intervention
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644017/
https://www.ncbi.nlm.nih.gov/pubmed/37969130
http://dx.doi.org/10.21037/tp-23-45
work_keys_str_mv AT gengliting theanalysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT tangxiaoyu theanalysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT huali theanalysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT liuhaipei theanalysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT renshaolong theanalysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT zhongwenwei theanalysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT zhangjianhua theanalysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT gengliting analysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT tangxiaoyu analysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT huali analysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT liuhaipei analysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT renshaolong analysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT zhongwenwei analysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention
AT zhangjianhua analysisofriskfactorsforrecurrentwheezingininfantsandclinicalintervention