Do clinical investigations predict long-term wheeze? A follow-up of pediatric respiratory outpatients.

de Jong, Carmen C. M.; Pedersen, Eva SL.; Goutaki, Myrofora; Trachsel, Daniel; Barben, Juerg; Kuehni, Claudia E (2019). Do clinical investigations predict long-term wheeze? A follow-up of pediatric respiratory outpatients. Pediatric pulmonology, 54(8), pp. 1156-1161. Wiley-Blackwell 10.1002/ppul.24347

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INTRODUCTION The contribution of clinical investigations to prediction of long-term outcomes of children investigated for asthma is unclear. AIM We performed a broad range of clinical tests and investigated whether they helped to predict long-term wheeze among children referred for evaluation of possible asthma. METHODS We studied children aged 6 to 16 years referred to two Swiss pulmonary outpatient clinics with a history of wheeze, dyspnea, or cough in 2007. The initial assessment included spirometry, fractional exhaled nitric oxide, skin prick tests, and bronchial provocation tests by exercise, methacholine, and mannitol. Respiratory symptoms were assessed with questionnaires at baseline and at follow-up 7 years later. Associations between baseline factors and wheeze at follow-up were investigated by logistic regression. RESULTS At baseline, 111 children were examined in 2007. After 7 years, 85 (77%) completed the follow-up questionnaire, among whom 61 (72%) had wheeze at baseline, while at follow-up 39 (46%) reported wheeze. Adjusting for age and sex, the following characteristics predicted wheeze at adolescence: wheeze triggered by pets (odds ratio, 4.2; 95% CI, 1.2-14.8), pollen (2.8, 1.1-7.0), and exercise (3.1, 1.2-8.0). Of the clinical tests, only a positive exercise test (3.2, 1.1-9.7) predicted wheeze at adolescence. CONCLUSION Reported exercise-induced wheeze and wheeze triggered by pets or pollen were important predictors of wheeze persistence into adolescence. None of the clinical tests predicted wheeze more strongly than reported symptoms. Clinical tests might be important for asthma diagnosis but medical history is more helpful in predicting prognosis in children referred for asthma.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)
Graduate School for Health Sciences (GHS)

UniBE Contributor:

de Jong, Carmen Cornelia Maria; Pedersen, Eva Sophie Lunde; Goutaki, Myrofora and Kühni, Claudia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

8755-6863

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

08 May 2019 11:18

Last Modified:

21 Jul 2019 01:31

Publisher DOI:

10.1002/ppul.24347

PubMed ID:

31026385

Uncontrolled Keywords:

asthma cohort epidemiology prognosis respiratory wheeze

BORIS DOI:

10.7892/boris.130380

URI:

https://boris.unibe.ch/id/eprint/130380

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