9:
Recurrent Wheeze After Hospital Discharge Among Preschool Children Hospitalized With Acute Wheezing: 18-Months Follow-Up of A Multi-Center Study.
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Patrada Thanee, M.D., Paskorn Sritipsukho, M.D., Orapan Poachanukoon, M.D., Araya Satdhabudha, M.D., Khlongtip Matchimmadamrong, M.D., Sasawan Chinratanapisit, M.D., Jitladda Deerojanawong, M.D., Pantipa Chatchatee, MD, Narissara Suratannon, M.D.
RATIONALE:

Recurrent wheeze in preschool children has various prognoses. This study aimed to determine times to recurrent wheeze after hospital discharge and explore factors associated with recurrent wheeze among preschool children.

METHODS:

This is a longitudinal study conducted among 240 hospitalized preschool children with acute wheezing, aged between 6 months to 5 years, in 4 tertiary hospitals. Demographic, environments and clinical characteristic data were collected. Serum samples were measured for specific IgE levels against common food and inhalant allergens, and for 25-hydroxyvitamin D (25OHD) concentrations. The participants have been followed for 18 months to record the outcomes including hospitalizations and emergency visits due to recurrent wheezing. Factors associated with recurrent wheeze after discharge was determined.

RESULTS:

Ninety-four cases (40.9%) were hospitalized with the first wheezing episode of their life. During 18 months of follow-up, the cumulative incidence of re-hospitalization and emergency visits due to recurrent wheeze was 23.1 percent (95% confidence interval: 18.1%-29.2%) and 49.7 percent (95% confidence interval: 43.5%-56.5%) respectively. Controllers including inhaled steroids and leukotriene receptor antagonist (LTRA) were prescribed at hospital discharge for 33.3% and 23.1% respectively. Being the second child or more, history of recurrent wheezing, allergic rhinitis, atopic dermatitis and vitamin D insufficiency were significantly associated with recurrent wheeze.

CONCLUSIONS:

Recurrent wheeze among preschool children hospitalized with acute wheezing was common. Being the second child or more in the family, history of recurrent wheeze, atopic diseases and vitamin D insufficiency were the significant risks of recurrent wheeze after hospital discharge.