Acute Bronchiolitis To Pediatric Inpatient Clinic In Patients Under 2 Years Old, Installed with Diagnosis Investigation of the Relationship of Bronchiolitis and Asthma
Bronchiolitis and Asthma Relatisionship
Keywords:
Bronchiolitis, phenotypes, asthma, childAbstract
Once deemed a uniform disease, research has revealed bronchiolitis as heterogeneous, with varying phenotypes and clinical-histopathological dissimilarities among patients. Identifying phenotypes in bronchiolitis is important for determining the correct treatment and predicting the possible development of asthma. Our aim was to explore distinctions among hospitalized children with acute, severe bronchiolitis and pinpoint potential asthma risk factors.
METHOD
From January 2017 to November 2022, our hospital admitted 156 patients below two years old with moderate to severe acute bronchiolitis. Patient attack severity was assessed using the bronchiolitis severity score developed by the Turkish Thoracic Society. Asthma risk was assessed using the modified Asthma Predictive Index (mAPI) score, designed for predicting future asthma in bronchiolitis cases.
RESULTS
One hundred fifty-six patients were investigated based on their history of previous hospitalization for acute bronchiolitis and mAPI characteristics.
Forty-one percent of patients had prior bronchiolitis hospitalizations (multiple hospitalization group), while 59% were first-time hospitalizations (first hospitalization group).
Middle rales, wheezing, and tachypnea were more frequent in the multi-hospitalization group, with a statistically significant difference. A rise of 1 unit in respiratory rate raised readmission risk by 1.048 times.
Assessing patients by "API," 64.1% were "API"(+), 35.9% were "API"(-). 69% "API"(+) patients were male, 48.3% "API"(-) patients were male - a significant difference. Wheezing occurred in 48% "API"(+) patients and 30.3% "API"(-) patients - also significant.
DISCUSSION - CONCLUSION
Our study indicated that the majority of bronchiolitis cases were linked to asthma, with a significant 48.7% having a family history. This major risk factor implies a prevalent asthma phenotype. Moreover, 41% with repeated hospitalizations and 64.1% API(+) reinforce this view.
In summary, it is important to identify patients at risk for asthma in the early period, to adjust the correct treatment, and to protect the patient's lung function.