Outcomes of young children hospitalized with acute wheezing
Sasawan Chinratanapisit,1 Paskorn Sritipsukho,2,3 Araya Satdhabudha,4 Khlongtip Matchimmadamrong,5 Jitladda Deerojanawong,6 Narissara Suratannon,7 Pantipa Chatchatee7
Affiliations:
1 Department of Pediatrics, Bhumibol Adulyadej Hospital, Thailand
2 Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Thammasat University
3 Center of Excellence in Applied Epidemiology, Thammasat University, Thailand
4 Division of Respiratory disease, Department of Pediatrics, Faculty of Medicine, Thammasat University, Thailand
5 Department of Pediatrics, Saraburi Hospital, Saraburi, Thailand
6 Division of Respiratory disease and intensive care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand
7 Pediatric Allergy & Clinical Immunology Research Unit, Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand
Abstract
Background: Wheezing in preschool children is a common symptom.
Objective: The study aimed to determine an incidence of recurrent wheezing among young children who had been hospitalized with acute wheezing after 12 months. Factors associated with recurrent wheezing were explored.
Methods: A longitudinal study was conducted among 236 children, aged between 6 months and 5 years, who were hospitalized with acute wheezing in 4 hospitals located in Bangkok and adjacent provinces, Thailand. Demographics, house environments and clinical characteristic data were collected at entry. Serum specific IgE levels against common food and inhalant allergens and serum 25-hydroxyvitamin D (25OHD) concentrations were measured.
Results: At entry, the mean age was 24.4 months (SD = 15.7 months). Of 236 hospitalized children with acute wheezing, ninety-four cases (39.8%) were the first wheezing episode of life. By laboratory results, 197 (83.5%) and 56 (23.7%) children were atopic and had vitamin D insufficiency respectively. There were 195 cases completely followed for 12 months. One-year risk of emergency visits and hospitalization due to recurrent wheezing were 49.7% and 23.1% respectively. By multivariable analysis, being the second born child or more, vitamin D insufficiency, “ever wheeze”, and allergic rhinitis were significantly associated with recurrent wheezing within 12 months with adjusted odds ratios of 2.5 (95% confidence interval: 1.3-5.3), 2.3 (95% confidence interval: 1.1-4.4), 1.9 (95% confidence interval: 1.2-3.5), and 1.6 (95% confidence interval: 1.3-2.9) respectively.
Conclusion: Being the second born child or more, vitamin D insufficiency, ever wheeze, and allergic rhinitis were significant risks of recurrent wheezing.
Key words: incidence, recurrent wheeze, preschool, hospitalization, risk factors,