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Randomized Controlled Trial
. 2009 Jun;154(6):877-81.e4.
doi: 10.1016/j.jpeds.2008.12.029. Epub 2009 Mar 25.

Signs and symptoms that precede wheezing in children with a pattern of moderate-to-severe intermittent wheezing

Katherine Rivera-Spoljaric  1 , Vernon M Chinchilli, Lindsay J Camera, Robert S Zeiger, Ian M Paul, Brenda R Phillips, Lynn M Taussig, Robert C Strunk, Leonard B Bacharier; Childhood Asthma Research and Education (CARE) Network
Collaborators, Affiliations
Randomized Controlled Trial

Signs and symptoms that precede wheezing in children with a pattern of moderate-to-severe intermittent wheezing

Katherine Rivera-Spoljaric et al. J Pediatr. 2009 Jun.

Abstract

Objectives: To examine parent-reported signs and symptoms as antecedents of wheezing in preschool children with previous moderate to severe wheezing episodes, and to determine the predictive capacity of these symptom patterns for wheezing events.

Study design: Parents (n = 238) of children age 12 to 59 months with moderate-to-severe intermittent wheezing enrolled in a year-long clinical trial completed surveys that captured signs and symptoms at the start of a respiratory tract illness (RTI). Sensitivity, specificity, negative predictive value, and positive predictive value (PPV) for each symptom leading to wheezing during that RTI were calculated.

Results: The most commonly reported first symptom categories during the first RTI were "nose symptoms" (41%), "significant cough" (29%), and "insignificant cough" (13%). The most reliable predictor of subsequent wheezing was significant cough, which had a specificity of 78% and a PPV of 74% for predicting wheezing.

Conclusions: Significant cough is the most reliable antecedent of wheezing during an RTI. It may be useful to consider individualized symptom patterns as a component of management plans intended to minimize wheezing episodes.

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Conflict of interest statement

Potential Conflicts of Interest: None

Figures

Figure 1
Figure 1
A,B,C. Histograms representing the frequencies of symptoms reported by parents as the very first symptom (1A), most important symptom (1B), and symptom to initiate study medication (1C) of a respiratory tract illness (RTI) 1A First symptom of a respiratory tract illness (RTI) 1B Most important symptom of a respiratory tract illness (RTI) 1C Symptom to initiate study medication during a respiratory tract illness (RTI)
Figure 1
Figure 1
A,B,C. Histograms representing the frequencies of symptoms reported by parents as the very first symptom (1A), most important symptom (1B), and symptom to initiate study medication (1C) of a respiratory tract illness (RTI) 1A First symptom of a respiratory tract illness (RTI) 1B Most important symptom of a respiratory tract illness (RTI) 1C Symptom to initiate study medication during a respiratory tract illness (RTI)
See this image and copyright information in PMC

References

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