Respiratory exacerbations in indigenous children from two countries with non-cystic fibrosis chronic suppurative lung disease/bronchiectasis

Redding, Gregory J., Singleton, Rosalyn J., Valery, Patricia C., Williams, Hayley, Grimwood, Keith, Morris, Peter S., Torzillo, Paul J., McCallum, Gabrielle B., Chikoyak, Lori, Holman, Robert C. and Chang, Anne B. (2014) Respiratory exacerbations in indigenous children from two countries with non-cystic fibrosis chronic suppurative lung disease/bronchiectasis. Chest, 146 3: 762-774. doi:10.1378/chest.14-0126


Author Redding, Gregory J.
Singleton, Rosalyn J.
Valery, Patricia C.
Williams, Hayley
Grimwood, Keith
Morris, Peter S.
Torzillo, Paul J.
McCallum, Gabrielle B.
Chikoyak, Lori
Holman, Robert C.
Chang, Anne B.
Title Respiratory exacerbations in indigenous children from two countries with non-cystic fibrosis chronic suppurative lung disease/bronchiectasis
Journal name Chest   Check publisher's open access policy
ISSN 1931-3543
0012-3692
Publication date 2014-09-01
Sub-type Article (original research)
DOI 10.1378/chest.14-0126
Open Access Status
Volume 146
Issue 3
Start page 762
End page 774
Total pages 13
Place of publication Northbrook, IL, United States
Publisher American College of Chest Physicians
Collection year 2015
Language eng
Formatted abstract
BACKGROUND: Acute respiratory exacerbations (AREs) cause morbidity and lung function decline in children with chronic suppurative lung disease (CSLD) and bronchiectasis. In a prospective longitudinal cohort study, we determined the patterns of AREs and factors related to increased risks for AREs in children with CSLD/bronchiectasis.

METHODS: Ninety-three indigenous children aged 0.5 to 8 years with CSLD/bronchiectasis in Australia (n = 57) and Alaska (n = 36) during 2004 to 2009 were followed for > 3 years. Standardized parent interviews, physical examinations, and medical record reviews were undertaken at enrollment and every 3 to 6 months thereafter.

RESULTS: Ninety-three children experienced 280 AREs (median = 2, range = 0-11 per child) during the 3-year period; 91 (32%) were associated with pneumonia, and 43 (15%) resulted in hospitalization. Of the 93 children, 69 (74%) experienced more than two AREs over the 3-year period, and 28 (30%) had more than one ARE in each study year. The frequency of AREs declined significantly over each year of follow-up. Factors associated with recurrent (two or more) AREs included age < 3 years, ARE-related hospitalization in the first year of life, and pneumonia or hospitalization for ARE in the year preceding enrollment. Factors associated with hospitalizations for AREs in the first year of study included age < 3 years, female caregiver education, and regular use of bronchodilators.

CONCLUSIONS
: AREs are common in children with CSLD/bronchiectasis, but with clinical care and time AREs occur less frequently. All children with CSLD/bronchiectasis require comprehensive care; however, treatment strategies may differ for these patients based on their changing risks for AREs during each year of care.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
Queensland Children's Medical Research Institute Publications
 
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Created: Tue, 11 Nov 2014, 15:40:07 EST by Matthew Lamb on behalf of School of Medicine