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Prediction of postinfectious bronchiolitis obliterans prognosis in children
Author(s) -
Jung Jae Hwa,
Kim Ga Eun,
Min In Kyung,
Jang Haerin,
Kim Soo Yeon,
Kim Min Jung,
Kim Yoon Hee,
Shin Hyun Joo,
Yoon Haesung,
Sohn Myung Hyun,
Lee MiJung,
Kim Kyung Won
Publication year - 2021
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.25220
Subject(s) - medicine , bronchiolitis obliterans , nomogram , bronchiolitis , spirometry , vital capacity , confidence interval , dlco , bronchodilator , respiratory system , lung , asthma , lung transplantation , diffusing capacity , lung function
The prognosis of postinfectious bronchiolitis obliterans (PIBO) has many implications, ranging between reduced quality of life and life‐threatening complications. We evaluated the prognostic factors for PIBO using the baseline clinical characteristics of patients and built a prediction model for determining the prognoses of PIBO patients using the identified parameters. Methods We included 47 PIBO patients who underwent spirometry and impulse oscillometry and followed them up for at least 1 year. A patient's prognosis was classified as poor if the patient experienced at least one of the following: persistent respiratory symptoms for more than 1 year, two or more instances of hospitalizations due to respiratory symptoms, or more than one intensive care unit admission. Results The prognoses of 32/47 (68.1%) patients was good, while that of 15/47 (31.9%) was poor. Spirometry results showed significantly lower forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1 ), forced expiratory flow at 25%–75% of FVC, and post‐bronchodilator (BD) FEV 1 values in the poor prognosis group; chest computed tomography (CT) demonstrated more inflammatory bronchiolitis findings. We created a nomogram for predicting prognoses using post‐BD FEV 1 and inflammatory bronchiolitis on chest CT. The area under the curve for the nomogram was 84.6% (95% confidence interval: 72.8%–96.4%). Conclusions PIBO patients with lower pulmonary function values and more findings of inflammatory bronchiolitis on initial examination have poor prognoses. The nomogram for predicting PIBO prognosis is easy to use and can be applied at the time of diagnosis.