The predictive factors in preschool wheezers for subsequent asthma hospitalization after the age of 6 years

Abstract

Background: Preschool children with wheeze may develop asthma later at school age. Positive skin prick test (SPT) to common aeroallergens in preschool wheezers may be associated with a higher chance of developing asthma at school age. Methods: All patients with SPT performed for the indication of preschool wheeze, i.e., before the age of 6 years, were included in the study from 1999 to 2011. Outcome measures including asthmatic attack requiring emergency hospitalization and the need for asthma controller prescription after the age of 6 years were retrieved from the hospital database. Potential risk factors including gender, family history of asthma, blood eosinophilia, environmental tobacco exposure, personal eczema, and allergic rhinitis were also retrieved for analysis. Multiple logistic regression was performed to identify independent risk factors. Results: Altogether, 463 children were included for analysis with mean age at SPT of 3.1 ± 1.36 years and 64.6% were male. Positive SPT results were obtained in 60.5% of patients. For preschool children with wheeze, female gender (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.04–3.46, P = 0.036), positive SPT (OR = 2.96, 95% CI: 1.40–6.24, P = 0.004), and late-onset preschool wheeze hospitalization (OR = 2.82, 95% CI: 1.42–5.61, P = 0.003) were associated with a higher chance of asthmatic hospitalization after the age of 6 years. Allergic rhinitis (OR = 4.58, 95% CI: 2.16–9.71, P < 0.001) and family history of asthma (OR = 1.82, 95% CI: 1.09–3.02, P = 0.022) were associated with higher chance for asthma controller prescription. Conclusion: For preschool wheeze, female gender, positive SPT, and late-onset preschool wheeze index are associated with a higher chance of asthmatic hospitalization after the age of 6 years while allergic rhinitis and family history of asthma are associated with a higher chance for asthma controller prescription after the age of 6 years.