First episode of preschool wheeze requiring hospitalization: a prospective study on the chance of recurrence and associated factors

Abstract

Background: Although wheezing is very common in preschoolers, epidemiologic studies in Thailand are quite limited. The likelihood of having a second wheezing episode following the first attack remains unclearly established. Objectives: This study aims to investigate the incidence of recurrent wheezing in preschool children presenting with first wheezing episode and identify the associated factors. Methods: The study is an observational prospective study conducted at the inpatient pediatric department. Patients admitted with first episode of wheezing were followed up as an outpatient approximately one week after hospital discharge and subsequently followed up by telephone 3-monthly with a structured questionnaire seeking information concerning recurrent wheezing, defined as having a second wheezing episode requiring bronchodilator within a 1-year period. Results: The total of 97 patients, aged 6 months to 5 years, were recruited from June 2014 to November 2015. Thirty-five patients were excluded because of inaccessibility for telephone follow-up. Amongst the remaining 62 patients, twenty-eight (45.2%) had recurrent wheezing within one year. The mean lapse duration was 4.7 ± 3.7 months after the first episode. Having an allergic sensitization to aeroallergen was a risk factor for recurrent wheezing (OR 2.48, 95%CI 1.81–3.4). Although not statistically significant, having an allergic sensitization to food seems to be another related factor (OR 2.36, 95%CI 1.75-3.18). Conclusion: The recurrent rate of wheezing was 45%, which was considerably significant. Allergic sensitization to aeroallergen might increase the risk. These patients should be followed up, especially within the first year after their first wheezing episode.