Background <p>Supervised clustering of bronchiolitis patients, according to their clinical characteristics at hospital admission, helps predict short-term hospital outcomes and the risk of developing childhood respiratory illness. Thus, we evaluated the use of wheezing status for stratifying bronchiolitis patients.</p> Methods <p>A prospective cohort study was conducted involving 668 previously healthy, full-term Chilean infants ( &lt; 2 years old) hospitalized with bronchiolitis. Patients categorized based on their wheezing status at hospital admission were monitored during hospitalization and followed for 4 years after discharge.</p> Results <p>Wheezing children presented a more severe illness requiring more oxygen during their hospital stay. Upon discharge, they were more likely to develop preschool wheezing at 12 months and asthma at 4 years of age. Among the non-wheezing, those with RSV had more severe disease. Risk factors exclusively associated with persistent asthma development for the wheezing were clinical bacterial coinfection, parental asthma history, and having had a severe bronchiolitis episode. Risk factors exclusive for non-wheezing were maternal smoking during pregnancy and severe retractions.</p> Conclusion <p>Bronchiolitis patients can be categorized based on their wheezing status at hospital admission, helping predict short-term clinical outcomes and identify infants at risk of developing severe short- and long-term respiratory illnesses.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Stratifying viral bronchiolitis patients using a simple bedside strategy based on their wheezing status at hospitalization can help improve individual-based clinical decisions during hospitalization and enable early identification of infants with a higher risk of developing severe respiratory illnesses and long-term associated diseases.</p> </ItemContent> <ItemContent> <p>Viral bronchiolitis patients can be stratified based on their hospitalized wheezing status.</p> </ItemContent> <ItemContent> <p>Wheezing patients exhibited similar clinical patterns during hospitalization and long-term clinical outcomes upon discharge.</p> </ItemContent> <ItemContent> <p>Wheezing infants were more likely to develop preschool wheezing and asthma.</p> </ItemContent> </UnorderedList></p>

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Wheezing on admission: a marker for bronchiolitis severity and asthma development

  • Patricio Astudillo,
  • Maria Rodriguez-Fernandez,
  • José A. Castro-Rodríguez,
  • Marcelo López-Lastra

摘要

Background

Supervised clustering of bronchiolitis patients, according to their clinical characteristics at hospital admission, helps predict short-term hospital outcomes and the risk of developing childhood respiratory illness. Thus, we evaluated the use of wheezing status for stratifying bronchiolitis patients.

Methods

A prospective cohort study was conducted involving 668 previously healthy, full-term Chilean infants ( < 2 years old) hospitalized with bronchiolitis. Patients categorized based on their wheezing status at hospital admission were monitored during hospitalization and followed for 4 years after discharge.

Results

Wheezing children presented a more severe illness requiring more oxygen during their hospital stay. Upon discharge, they were more likely to develop preschool wheezing at 12 months and asthma at 4 years of age. Among the non-wheezing, those with RSV had more severe disease. Risk factors exclusively associated with persistent asthma development for the wheezing were clinical bacterial coinfection, parental asthma history, and having had a severe bronchiolitis episode. Risk factors exclusive for non-wheezing were maternal smoking during pregnancy and severe retractions.

Conclusion

Bronchiolitis patients can be categorized based on their wheezing status at hospital admission, helping predict short-term clinical outcomes and identify infants at risk of developing severe short- and long-term respiratory illnesses.

Impact

Stratifying viral bronchiolitis patients using a simple bedside strategy based on their wheezing status at hospitalization can help improve individual-based clinical decisions during hospitalization and enable early identification of infants with a higher risk of developing severe respiratory illnesses and long-term associated diseases.

Viral bronchiolitis patients can be stratified based on their hospitalized wheezing status.

Wheezing patients exhibited similar clinical patterns during hospitalization and long-term clinical outcomes upon discharge.

Wheezing infants were more likely to develop preschool wheezing and asthma.