K M Eastham1, D M Hammal, L Parker, D A Spencer. 1. School of Clinical Medical Sciences (Child Health), University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Abstract
OBJECTIVE: To investigate the outcome for children hospitalised with radiologically confirmed community-acquired pneumonia (CAP) DESIGN: Controlled follow-up study. SETTING: Community based in Newcastle upon Tyne, North Tyneside and Northumberland schools. PATIENTS: 103 cases of radiologically confirmed CAP a median of 5.6 years (range 4.4-7.4) after admission to Newcastle General Hospital, matched for sex and school class to a mean of two controls (n = 248). INTERVENTIONS: A respiratory questionnaire, clinical examination and spirometry measurements. MAIN OUTCOME MEASURES: Multiple regression was used to describe associations between explanatory variables, including CAP, and outcome variables: forced expiratory volume in 1 s percent predicted (FEV(1) %), forced vital capacity percent predicted (FVC %), persistent cough, doctor diagnosis of asthma and abnormal chest shape. RESULTS: Cases were 2.9 times more likely (95% CI 1.45 to 5.71, p = 0.020) than controls to have persistent cough and 5.5 times more likely to have an abnormal chest shape (95% CI 1.65 to 18.28, p = 0.005). Cases of an atopic parent had a 7.0% deficit in FEV(1) % predicted (95% CI -10.5 to -3.2, p<0.001) and a 4.4% deficit in FVC % predicted (95% CI -8.0 to -0.78, p = 0.017), but were not at increased risk of subsequent asthma. Cases of a non-atopic parent were at increased risk of subsequent asthma (OR 4.8, 95% CI 1.43 to 16.34, p = 0.011) but not of deficit in lung function. CONCLUSIONS: CAP requiring admission to hospital is associated with deficits in lung function and persistent respiratory symptoms. This has implications for follow-up for which recommendations are currently lacking. Parental atopy may be a determinant of outcome.
OBJECTIVE: To investigate the outcome for children hospitalised with radiologically confirmed community-acquired pneumonia (CAP) DESIGN: Controlled follow-up study. SETTING: Community based in Newcastle upon Tyne, North Tyneside and Northumberland schools. PATIENTS: 103 cases of radiologically confirmed CAP a median of 5.6 years (range 4.4-7.4) after admission to Newcastle General Hospital, matched for sex and school class to a mean of two controls (n = 248). INTERVENTIONS: A respiratory questionnaire, clinical examination and spirometry measurements. MAIN OUTCOME MEASURES: Multiple regression was used to describe associations between explanatory variables, including CAP, and outcome variables: forced expiratory volume in 1 s percent predicted (FEV(1) %), forced vital capacity percent predicted (FVC %), persistent cough, doctor diagnosis of asthma and abnormal chest shape. RESULTS: Cases were 2.9 times more likely (95% CI 1.45 to 5.71, p = 0.020) than controls to have persistent cough and 5.5 times more likely to have an abnormal chest shape (95% CI 1.65 to 18.28, p = 0.005). Cases of an atopic parent had a 7.0% deficit in FEV(1) % predicted (95% CI -10.5 to -3.2, p<0.001) and a 4.4% deficit in FVC % predicted (95% CI -8.0 to -0.78, p = 0.017), but were not at increased risk of subsequent asthma. Cases of a non-atopic parent were at increased risk of subsequent asthma (OR 4.8, 95% CI 1.43 to 16.34, p = 0.011) but not of deficit in lung function. CONCLUSIONS: CAP requiring admission to hospital is associated with deficits in lung function and persistent respiratory symptoms. This has implications for follow-up for which recommendations are currently lacking. Parental atopy may be a determinant of outcome.
Authors: Karen Edmond; Susana Scott; Viola Korczak; Catherine Ward; Colin Sanderson; Evropi Theodoratou; Andrew Clark; Ulla Griffiths; Igor Rudan; Harry Campbell Journal: PLoS One Date: 2012-02-22 Impact factor: 3.240