Risk factors associated with wheezing in severe pediatric community-acquired pneumonia: a retrospective study.

IF 2.6 4区 医学 Q2 Medicine
Minerva pediatrica Pub Date : 2024-06-01 Epub Date: 2021-01-13 DOI:10.23736/S2724-5276.20.06065-X
Lumin Chen, Chong Miao, Yanling Chen, Xian Han, Ziying Lin, Hong Ye, Chengyi Wang, Huijie Zhang, Jingjing Li, Xi Liu, Libo Xu, Guanghua Liu
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引用次数: 0

Abstract

Background: Wheezing is a common clinical manifestation in children with pneumonia. However, the risk factors associated with the development of wheezing pneumonia and its clinical features are not fully characterized, especially in children with severe pneumonia.

Methods: We retrospectively recruited 1434 pediatric patients diagnosed with severe pneumonia between April 2012 and September 2019 in Fujian Maternity and Child Health Hospital. The medical records regarding demographic information, clinical manifestations, radiographic/laboratory findings, and complications were collected. Based on the presence or absence of wheezing symptoms and signs, subjects were divided into wheezing cohort (N.=684) and non-wheezing cohort (N.=750), and their clinical data were compared. Multivariate cox regression analysis was performed to identify independent risk factors of wheezing.

Results: Demographic features including gender, weigh, onset season, birth weight, full-term birth or not, history of pneumonia were significantly associated with the occurrence of wheezing in severe CAP (P<0.05). Specifically, male gender, onset seasons in autumn/winter, and absence of a history of pneumonia were identified as independent risk factors of wheezing in multivariate analysis (P<0.05). As for clinical features, wheezing cohort differed from the non-wheezing one in terms of clinical manifestation (higher incidence of cough and breathless, but lower incidence of fever), laboratory finding (higher levels of red blood cells, hemoglobin, and albumin and lower levels of total or indirect bilirubin and creatine), pathogen detection (higher incidence of respiratory syncytial viral infection), and clinical complications (lesser risk of sepsis and hydrothorax) (P<0.05).

Conclusions: Severe CAP with wheezing is a special clinical entity of severe pneumonia in children, which has specific risk factors and differ from non-wheezing pneumonia in terms of clinical features and etiologic pathogens.

与严重儿科社区获得性肺炎喘息相关的风险因素:一项回顾性研究。
背景:喘息是肺炎患儿常见的临床表现。然而,与喘息性肺炎发病相关的危险因素及其临床特征尚未完全定性,尤其是在重症肺炎患儿中:我们回顾性招募了福建省妇幼保健院 2012 年 4 月至 2019 年 9 月期间确诊为重症肺炎的 1434 例儿童患者。收集有关人口学信息、临床表现、影像学/实验室检查结果和并发症的病历资料。根据有无喘息症状和体征,将受试者分为喘息队列(684人)和非喘息队列(750人),并比较他们的临床数据。通过多变量考克斯回归分析确定喘息的独立风险因素:结果:性别、体重、发病季节、出生体重、是否足月分娩、肺炎史等人口统计学特征与重症 CAP 患者喘息的发生有显著相关性(结论:重症 CAP 患者喘息的发生率与其他风险因素有显著相关性:重症 CAP 伴喘息是儿童重症肺炎的一种特殊临床表现,具有特殊的风险因素,在临床特征和病原体方面与非喘息性肺炎不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Minerva pediatrica
Minerva pediatrica PEDIATRICS-
CiteScore
2.70
自引率
3.80%
发文量
1
审稿时长
>12 weeks
期刊介绍: Minerva Pediatrica publishes scientific papers on pediatrics, neonatology, adolescent medicine, child and adolescent psychiatry and pediatric surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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