高收入国家 12 岁以下儿童患中耳炎伴流脓的可改变风险因素:系统综述。

IF 4.3 3区 医学 Q1 PEDIATRICS
Aye Paing, Laura Elliff-O'Shea, John Day, Devavrata Joshi, Stephanie Arnold, Tamsin Holland Brown, Veronica Kennedy
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引用次数: 0

摘要

目的系统评估 12 岁以下儿童患中耳炎伴流脓(OME)的可改变风险因素:我们检索了Embase、MEDLINE、INAHTA数据库、CENTRAL、CDSR和Epistemonikos数据库中2000年至2022年11月期间用英语发表的每组/预后因素≥40名儿童的队列研究。我们使用预后研究质量核对表评估了偏倚风险,并使用建议评估、发展和评价分级(GRADE)方法评估了总体证据质量。结果以风险比(RR)、OR或Peto OR进行分析:共纳入七项研究,涉及 2 760 292 名儿童。证据质量很低。耳朵流出液体或脓液(OR 2.1,95% CI 1.01 至 4.35)和接触其他儿童(RR 2.79,95% CI 1.98 至 3.93)(OR 5.21,95% CI 2.9 至 9.36)与 OME 的发生密切相关。过去一年中,咳嗽/发冷≥5次(OR 1.91,95% CI 1.22至2.99)、呼吸困难≥5次(RR 1.78,95% CI 1.26至2.53)和中耳感染(RR 1.95,95% CI 1.39至2.72)与OME的发生密切相关。腺样体肥大与波动性 OME(复发性 OME)的发生密切相关(OR 9.96,95% CI 5.17 至 19.19)。有证据表明,母乳喂养、家庭吸烟、胃食管反流、使用假奶瓶和游泳等一些潜在的可改变的风险因素存在危险:结论:上呼吸道感染、耳部感染、腺样体肥大和与其他儿童的接触可能是诱发OME的因素。需要进一步开展观察研究,以调查其他潜在的可改变风险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modifiable risk factors for developing otitis media with effusion in children under 12 years in high-income countries: a systematic review.

Objective: To systematically assess the modifiable risk factors for developing otitis media with effusion (OME) in children under 12 years.

Methods: We searched Embase, MEDLINE, INAHTA database, CENTRAL, CDSR and Epistemonikos for cohort studies with ≥40 children per arm/prognostic factor, published in English from 2000 to November 2022. We assessed risk of bias using the Quality in Prognosis Studies checklist, and overall evidence quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Outcomes were analysed as risk ratio (RR), OR or Peto OR.

Results: Seven studies totalling 2 760 292 children were included. The evidence was very low quality. Fluid or pus discharge from ears (OR 2.1, 95% CI 1.01 to 4.35) and exposure to other children (RR 2.79, 95% CI 1.98 to 3.93) (OR 5.21, 95% CI 2.9 to 9.36) were strongly associated with development of OME. Coughs/colds ≥5 times (OR 1.91, 95% CI 1.22 to 2.99), breathing problems ≥5 times (RR 1.78, 95% CI 1.26 to 2.53) and ear infections (RR 1.95, 95% CI 1.39 to 2.72) in past year were associated with development of OME. Adenoid hypertrophy was strongly associated with development of fluctuating OME (recurrent OME) (OR 9.96, 95% CI 5.17 to 19.19). There was scare evidence for some potential modifiable risk factors, including breast feeding, household smoking, gastro-oesophageal reflux, dummy use and swimming.

Conclusions: Upper respiratory tract infection, ear infection, adenoid hypertrophy and exposure to other children could be the predictors for development of OME. Further observational studies are needed to investigate other potential modifiable risk factors.

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来源期刊
CiteScore
5.80
自引率
3.80%
发文量
291
审稿时长
3-6 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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