Related Experiment Videos
Childhood wheezing syndromes and healthcare data
Anita L Kozyrskyj1, Cameron A Mustard, Allan B Becker
1Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada. kozyrsk@cc.umanitoba.ca
Insights
Healthcare data reveals distinct childhood bronchitis syndromes beyond asthma. Transient bronchitis involves winter-only care and no allergies, while recurrent bronchitis is linked to prematurity, winter care, no allergies, and lower socioeconomic status.
Area of Science:
- Pediatric Medicine
- Respiratory Medicine
- Epidemiology
Background:
- Childhood wheezing encompasses various syndromes, necessitating differentiation from asthma.
- Healthcare utilization patterns may offer insights into distinct wheezing phenotypes.
Purpose of the Study:
- To identify distinct childhood wheezing syndromes using healthcare utilization profiles.
- To differentiate these syndromes from childhood asthma.
Main Methods:
- Analysis of population-based healthcare administrative data for children aged 5-15 years.
- Cohort followed from birth to 1995, with a follow-up period from January 1996 to March 1998.
- Identification of children with bronchitis but no asthma diagnoses.
Main Results:
- Two distinct bronchitis entities identified: transient and recurrent.
- Transient bronchitis associated with winter-only healthcare use and absence of allergies.
- Recurrent bronchitis linked to winter-only healthcare use, prematurity, absence of allergies, and low socioeconomic status.
Conclusions:
- Healthcare administrative data can delineate the natural history of childhood wheezing.
- Specific markers can differentiate bronchitis syndromes from asthma in children.
- Distinct wheezing syndromes in children warrant targeted diagnostic and management strategies.
Abstract:
There is convincing evidence that several distinct wheezing syndromes exist in childhood. The purpose of this research was to assess the potential of using healthcare utilization profiles to identify wheezing syndromes in children which are distinct from asthma. Using population-based healthcare administrative data, a cohort of children, aged 5-15 years, with bronchitis diagnoses from time of birth to 1995, but no physician diagnoses of asthma, was followed over the period January 1996-March 1998. In this follow-up period, 13% had subsequent healthcare utilization for asthma, 23% had continued healthcare utilization for bronchitis, and 64% had no further healthcare utilization. The likelihood of bronchitis vs. asthma outcomes was determined for a variety of asthma risk factors. In a cohort of 11,043 children with initial healthcare contact for bronchitis but not asthma, two potentially distinct entities of bronchitis emerged from our data: 1) transient bronchitis, similar to transient wheezing of early childhood, which was associated with winter-only healthcare utilization and absence of allergy, and 2) recurrent bronchitis which differed from asthma on the basis of winter-only healthcare utilization, prematurity at birth, absence of allergy, and low socioeconomic status. Healthcare administrative records can be used to describe the natural history of wheezing in children and to identify markers which may discriminate asthma from other syndromes.