The risk factors associated with severe wheeze episode in preschool children

Ozet Abstract Amac: Okul oncesi yas grubunda agir hisilti atagi ile iliskili risk faktorlerini belirlemektir. Yontem: Ocak 2013 ile Haziran 2013 tarihleri arasinda Inonu Universitesi Turgut Ozal Tip Merkezi Cocuk Alerji ve Astim poliklinigi ile Cocuk Acil poliklinigine, tekrarlayan agir hisilti atagi ile basvuran alti yasindan kucuk hastalarin dosyalari geriye donuk olarak incelendi. Bulgular: Alti aylik surede her iki poliklinige (cocuk alerji ve cocuk acil) 70 cocuk agir hisilti atagi ile basvurmustu. Calismaya, karsilastirma yapabilmek icin ayni yasta hafif hisilti atagi ile basvuran 72 cocuk hasta da dahil edildi. Agir hisilti atak tanisi konulan olgularin 49 (%68,1)’u erkek idi ve ortanca yasi 30 ay (6-60) idi. Hastalarin ilk gecirdikleri atak yasinin ortancasi 6 ay (1-60), son bir yil icerisindeki atak sayisinin ortancasi 5 (1-10) ve son bir yilda sistemik steroid gerektiren atak sayisinin ortancasi 2 (1-10) idi. Modifiye astim prediktif indeks hastalarin 27 (%38,1)’sinde pozitifti ve 29 hastada (%41,4) hisilti coklu tetiklenen hisilti fenotipindeydi. Agir hisilti atagi erkek cinsiyette (p=0,004) ve pasif sigara maruziyeti olan cocuklarda (p=0,011) daha fazlaydi. Ayrica son 1 yilda atak sikligi (p=0,029) ve sistemik steroid gerektiren atak sayisi da (p=0,001) agir hisilti atagi ile basvuran hastalarda daha fazlaydi. Sonuc: Agir hisilti atagi erkek cinsiyette, pasif sigara maruziyeti olan cocuklarda, son bir yilda hisilti ataklari sik olan ve sistemik steroid gerektiren hastalarda daha fazla gorulmektedir. Bu nedenle hisiltisi olan cocuklarin son 1 yildaki hisilti oykuleri detayli bir sekilde sorgulanmali ve sigara maruziyeti onlenmelidir. Objective: To determine the risk factors which associated with severe wheeze episode in preschool children Method: Between January 2013 and June 2013, the files of the patients, who were seen as severe wheeze episode and under 6 years old at the time of application, were analyzed retrospectively in the pediatric allergy and pediatric emergency department of Inonu University Turgut Ozal Medical Center Results: During the six month period, 70 children applied to two clinics (pediatric allergy and pediatric emergency) due to severe wheeze episode. Seventy-two children who applied with mild wheeze episode were included in the study to compare with severe wheeze episode. Forty-nine patients (68.1%) who were diagnosed with severe wheeze episode were male and the median age was 30 (6-60) months. The median age of first wheeze episode was 6 (160) months, median episode of wheeze number in the previous year was 5 (1-10) and median episode of wheeze required systemic steroid in the previous year was 2 (1-10). Modified Asthma Predictive Index was positive in 27 patients (38.1%) and wheeze was the multiple-trigger phenotype in 29 patients (41.1%). Severe wheeze episode was more in male gender (p=0.004) and in children who exposure to passive smoking (p=0.011). Also, frequency of wheeze episode (p=0.029) and required systemic steroid (p=0.001) in previous year were more in the patients with severe wheeze episode Conclusion: Severe wheeze episode were seen more in the patient who were male gender, exposure to passive smoking, have frequent wheeze episode and require systemic steroid in previous year. Therefore detailed previous year history of wheeze should be questioned in the patient who have wheeze and exposure of passive smoking should be prevented