Childhood wheezing syndromes and healthcare data

Abstract

There is convincing evidence that several distinct wheezing syndromes exist in childhood. The purpose of this research was to assess the potential of using healthcare utilization profiles to identify wheezing syndromes in children which are distinct from asthma. Using population-based healthcare administrative data, a cohort of children, aged 5-15 years, with bronchitis diagnoses from time of birth to 1995, but no physician diagnoses of asthma, was followed over the period January 1996-March 1998. In this follow-up period, 13% had subsequent healthcare utilization for asthma, 23% had continued healthcare utilization for bronchitis, and 64% had no further healthcare utilization. The likelihood of bronchitis vs. asthma outcomes was determined for a variety of asthma risk factors. In a cohort of 11,043 children with initial healthcare contact for bronchitis but not asthma, two potentially distinct entities of bronchitis emerged from our data: 1) transient bronchitis, similar to transient wheezing of early childhood, which was associated with winter-only healthcare utilization and absence of allergy, and 2) recurrent bronchitis which differed from asthma on the basis of winter-only healthcare utilization, prematurity at birth, absence of allergy, and low socioeconomic status. Healthcare administrative records can be used to describe the natural history of wheezing in children and to identify markers which may discriminate asthma from other syndromes.