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Effect of diagnosis delay on pulmonary function in children with asthma
Xiaoling Wei1,2,3, Min Xue1,2,3, Jinyan Yan1
1Department of Respiratory Diseases, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, 250022, Shandong, China.
Insights
Delayed asthma diagnosis in children impairs lung function, but early diagnosis and treatment can quickly improve it. This study highlights the importance of timely intervention for better pediatric asthma outcomes.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Investigating the impact of delayed asthma diagnosis on pediatric lung function is crucial.
- Previous research has limited data on the long-term effects of delayed diagnosis in children with asthma.
Purpose of the Study:
- To analyze the effect of delayed asthma diagnosis duration on lung function in children.
- To identify factors associated with delayed diagnosis and their impact on pulmonary function.
Main Methods:
- Retrospective cohort study conducted at Jinan Children's Hospital (2010-2020).
- Included 1,014 children with asthma, categorized by rhinitis, age at onset, and diagnosis delay duration (≤3 months to >5 years).
- Assessed lung function using %predicted forced volume capacity (FVC%pred) and %predicted forced expiratory volume in 1 second (FEV1%pred).
Main Results:
- Median diagnostic delay was 11 months; longer delays and younger age at onset were linked to lower lung function (FVC%pred, FEV1%pred).
- Females had shorter diagnosis delays and higher initial FVC%pred than males.
- While initial lung function was impaired across delay groups, it improved significantly after 3-6 months of standardized treatment, particularly FVC%pred.
Conclusions:
- Delayed asthma diagnosis negatively impacts children's lung function.
- Early diagnosis and prompt, standardized treatment are essential for improving lung function in pediatric asthma.
- Lung function can recover effectively with timely and appropriate medical intervention.
Background:
The effects of a delayed diagnosis of asthma on lung function in children have not been well investigated. Therefore, a retrospective cohort study was conducted in a children's hospital to analyse the effect of delayed diagnosis time on lung function in children with asthma.
Methods:
We conducted a retrospective cohort study in Jinan Children's Hospital from January 1, 2010, to December 31, 2020. All children were divided into different groups according to the presence or absence of rhinitis, age at first onset (first coughing and wheezing attack) and delayed diagnosis duration (≤ 3 months, 3-12 months, 1-3 years, 3-5 years and > 5 years).
Results:
A total of 1,014 children with asthma were included in this study. The median (quartile) delay in asthma diagnosis among all participants was 11 (2, 26) months. The shortest delay in diagnosis time was on the same day of onset, and the longest delay in diagnosis time was 10 years. The median (quartile) duration of delayed diagnosis was 10 (2, 26) months in 307 asthmatic children without rhinitis and 11 (2, 26) months in 707 children with asthma and rhinitis (P < 0.05). The delayed diagnosis time was shorter among female children than among male children (P < 0.05), and the first %predicted forced volume capacity (FVC%pred) results for females were higher than those for males (P = 0.036). The children whose age at first asthma onset was ≤ 3 years had a longer delayed diagnosis duration than those whose age at first onset was > 3 years (P < 0.05). The FVC%pred and %predicted forced expiratory volume in 1 s (FEV1%pred) in the first and second pulmonary function tests were significantly lower in the five delayed diagnosis groups (all P < 0.05). After standardised treatment for 3-6 months, FVC%pred showed a significant difference in the third test among the 5 groups (P < 0.05), but the other pulmonary function indices showed no significant difference. Logistic regression analysis showed that longer delay and young age of onset were associated with lower lung function (P < 0.05), whereas sex, rhinitis and eczema had no significant effects (all P > 0.05) on FVC%pred and FEV1%pred.
Conclusion:
Although delayed asthma diagnosis can lead to lung function impairment in children with asthma, lung function can be improved quickly after standardised treatment. Therefore, early asthma diagnosis and standardised treatment are very important.
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