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A 2- to 3-year outcome after bronchiolitis
M Korppi1, T Reijonen, L Pöysä
1Department of Pediatrics, Kuopio University Hospital, Finland.
Insights
Children hospitalized for bronchiolitis are likely to wheeze later, unlike those with pneumonia. Atopic conditions are linked to initial wheezing, but no specific risk factors predict later wheezing.
Area of Science:
- Pediatric Respiratory Medicine
- Epidemiology of Childhood Illnesses
Background:
- Early childhood respiratory infections like bronchiolitis and pneumonia are common.
- Understanding long-term outcomes is crucial for pediatric respiratory health management.
Purpose of the Study:
- To identify risk factors for subsequent wheezing in children.
- To determine the short-term outcome (until 3 years of age) of bronchiolitis and pneumonia regarding wheezing.
Main Methods:
- Prospective follow-up study of 108 children under 2 years of age.
- Patients were hospitalized for wheezing or pneumonia at a university hospital.
- Follow-up was conducted until 3 years of age.
Main Results:
- Subsequent wheezing occurred in 76% (1-2 years) and 58% (2-3 years) of children after bronchiolitis.
- Significantly fewer children (9-16%) experienced subsequent wheezing after pneumonia.
- History of wheezing, atopic eczema, and elevated IgE were more common in the initial wheezing group.
Conclusions:
- Bronchiolitis frequently leads to subsequent wheezing, while pneumonia has a lower incidence.
- Atopic diathesis is associated with initial wheezing episodes.
- No significant genetic or environmental risk factors were identified for later wheezing.
Objective:
To determine the risk factors and short-term outcome until 3 years of age for subsequent wheezing in children with early childhood bronchiolitis or pneumonia.
Design:
Prospective follow-up of a patient group.
Setting:
University hospital providing primary care for all pediatric patients of a defined area.
Patients:
One hundred twenty-seven children under 2 years of age hospitalized owing to wheezing (n = 83) or pneumonia (n = 44) during 12 months in 1981 to 1982. One hundred eight children completed the prospective follow-up until 3 years of age.
Interventions:
None.
Main Results:
The wheezing and pneumonia groups had equal viral and bacterial etiologic findings. History of wheezing, atopic eczema, and elevated serum IgE levels were more common in patients with wheezing than with pneumonia. Subsequent wheezing was seen after bronchiolitis in 76% (61 of 80) of the children at 1 to 2 years of age and in 58% (44 of 76) at 2 to 3 years of age. The respective figures were significantly lower, 9% (three of 33) and 16% (five of 32), in patients with pneumonia. An analysis of risk factors did not reveal any with a significant effect on subsequent wheezing.
Conclusions:
Subsequent wheezing is common after bronchiolitis, but rare after early childhood pneumonia, although caused by the same viruses or bacteria. Atopic diathesis is the host factor associated with initial wheezing. No genetic or environmental risk factor had significant association with later wheezing.