RT Journal Article
SR Electronic
T1 Prediction of wheeze recurrence and severity in infants by composite epidemiological score
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1147
VO 42
IS Suppl 57
A1 M.P. van der Schee
A1 S. Hashimoto
A1 A.C. Schuurman
A1 N. Adriaens
A1 A.B. Sprikkelman
A1 E.G. Haarman
A1 W.M.C. van Aalderen
A1 P.J. Sterk
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P1147.abstract
AB Rationale-Pre-school wheezing is associated with a diagnosis of asthma atschool-age. It is unclear to what extend early life epidemiological markers can predict wheeze severity and recurrence. Hypothesis-A composite score based on epidemiological data collected < 1 year can predict wheeze recurrence and severity at age 2.5. Methods-We aim to study this by analyzing data from the unselected, prospective EUROPA birth cohort. Potential predictors collected by telephone questionnaire were demographical data, family history, pregnancy, labour and perinatal circumstances. Wheeze recurrence and severity was assessed at age 2 and 2.5 by an ISAAC-based internet questionnaire. Severity was defined by a composite score based on wheeze frequency, night symptoms, hospitalisations and wheeze apart from colds. Odds Ratio (OR) for wheeze recurrence was calculated. Significant predictors were combined by CDA and ROC for sensitivity and specificity. Logistic regression identified potential severity predictors. Results-100 Infants with and 685 without recurrent wheeze were included. Parental hay fever (OR=2.57), parental asthma (1.95), male gender (1.91) and antenatal smoke exposure (1.89) were independently associated with wheeze at age 2.5. An algorithm based on these markers predicted wheeze recurrence with an AUC of 0.70±0.03, sens 71%, spec 64%. No markers were associated with the severity score.Conclusion-A composite score of epidemiological markers at age 1 has a moderate predictive potential for the presence but not severity of recurrent wheeze at age 2.5. Simple epidemiological markers can help to identify infants at increased risk of sustained wheezing, but additional (bio)markers are needed.