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Latent class identification in wheezing preschool children

Salvatore Fasola, Giovanna Cilluffo, Velia Malizia, Giuliana Ferrante, Laura Montalbano, Marco Montalbano, Giovanni Viegi, Stefania La Grutta
European Respiratory Journal 2016 48: PA3136; DOI: 10.1183/13993003.congress-2016.PA3136
Salvatore Fasola
1Institute of Biomedicine and Molecular Immunology “A. Monroy” (IBIM), National Research Council (CNR), Palermo, Italy
2Department of Economical, Business and Statistical Sciences, University of Palermo, Palermo, Italy
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Giovanna Cilluffo
1Institute of Biomedicine and Molecular Immunology “A. Monroy” (IBIM), National Research Council (CNR), Palermo, Italy
2Department of Economical, Business and Statistical Sciences, University of Palermo, Palermo, Italy
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Velia Malizia
1Institute of Biomedicine and Molecular Immunology “A. Monroy” (IBIM), National Research Council (CNR), Palermo, Italy
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Giuliana Ferrante
3Department of Science for Heath Promotion and Mother and Child Care, University of Palermo, Palermo, Italy
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Laura Montalbano
1Institute of Biomedicine and Molecular Immunology “A. Monroy” (IBIM), National Research Council (CNR), Palermo, Italy
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Marco Montalbano
1Institute of Biomedicine and Molecular Immunology “A. Monroy” (IBIM), National Research Council (CNR), Palermo, Italy
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Giovanni Viegi
1Institute of Biomedicine and Molecular Immunology “A. Monroy” (IBIM), National Research Council (CNR), Palermo, Italy
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Stefania La Grutta
1Institute of Biomedicine and Molecular Immunology “A. Monroy” (IBIM), National Research Council (CNR), Palermo, Italy
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Abstract

Background and aim: Since the forced oscillation technique (FOT) has not been used in previous studies on wheezing phenotyping in preschool children, we applied FOT in a large series of outpatients visited at IBIM.

Methods: We analyzed 256 consecutively enrolled ≤5 years children with doctor diagnosis of wheezing. Latent Class Analysis (LCA) was performed considering the following personal characteristics: type, cause, recurrence in last 12 months, respiratory resistance (Avr_R(8)), atopy, history of eczema, rhinitis and upper airways infections. High resistance is defined as positive residual of regression on sex, age, height and weight. Risk factors were considered meaningful when they yielded a p-value <0.10 in ANOVA and Chi-square tests. Analyses were performed through R version 3.2.0.

Results: Two latent classes were identified. In the first class (71%), children had mainly persistent (59%) and recurrent (50%) wheezing, with high resistance (56%; mean value 9.73±2.75 hPa/(l/s), mean residual 0.35±2.67 hPa/(l/s)) and high prevalence rate of upper airways infections (53%). In the second class (29%), wheezing was mainly late-onset (54%) and episodic (67%), with low resistance (65%; mean value 8.91±2.64 hPa/(l/s), mean residual -0.34±2.48 hPa/(l/s)) and high prevalence rates of rhinitis (76%) and atopy (79%). Membership in the first class was linked to be non-firstborn (p=0.075) and to have history of bronchiolitis (p<0.01). Membership in the second class was associated with older mean age (p<0.01), parental history of allergic diseases (p=0.06) and history of mold exposure (p=0.024).

Conclusions: Considering respiratory resistance can improve wheezing phenotype characterization in preschool children.

  • Wheezing
  • Airway management
  • Children
  • Copyright ©the authors 2016
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Latent class identification in wheezing preschool children
Salvatore Fasola, Giovanna Cilluffo, Velia Malizia, Giuliana Ferrante, Laura Montalbano, Marco Montalbano, Giovanni Viegi, Stefania La Grutta
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3136; DOI: 10.1183/13993003.congress-2016.PA3136

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Latent class identification in wheezing preschool children
Salvatore Fasola, Giovanna Cilluffo, Velia Malizia, Giuliana Ferrante, Laura Montalbano, Marco Montalbano, Giovanni Viegi, Stefania La Grutta
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3136; DOI: 10.1183/13993003.congress-2016.PA3136
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