Risk Factors Of Post-Bronchiolitis Rucurrent Wheezing In Infants And The Establishment Of A Nomogram Pridiction Model

Objective: To investigate and analyze the related factors of recurrent wheezing after bronchiolitis in infants,identify the risk factors,and establish a nomogram prediction modelMethods: The infants diagnosed as "bronchiolitis" in the Children's Hospital of Chongqing Medical University during the period of2016.01-2016.03 were selected,and the baseline data,clinical characteristics,laboratory examination and so on were collected and sorted out.Follow-up study was performed by telephone to investigate the wheezing situation of the children within 3 years after discharge.The children were divided into recurrent wheezing group and non-recurrent wheezing group according to wheezing times(whether ?3 times).Independent risk factors were screened by single factor analysis and multivariate logistic regression analysis,and a nomogram model was established based on independent risk factors to predict the risk of post-bronchiolitis recurrent wheezing in infants.Results: This study followed up successfully 270 hospitalized infants with bronchiolitis,of which 12.2% had recurrent wheezing.The cases were divided into recurrent wheezing group(33 cases)and non-recurrent wheezing group(237 cases).A single-factor and multivariate logistic regression analysis of the baseline data,clinical features and laboratory examination of the two groups was conducted,it turns out that family history of asthma(OR=3.249,95%CI=1.320-7.999)? tobacco exposure(OR=5.757,95%CI=2.423-13.678)? RSV infectionOR=3.745,95%CI=1.205-11.639)were independent risk factors of post-bronchiolitis recurrent wheezing in infants(p<0.05).Based on the above three risk factors,a nomogram model was established to predict the risk of post-bronchiolitis recurrent wheezing in infants.The nomogram model was validated by using bootstrap internal validation method,and roc area under the curve to predict the risk of post-bronchiolitis recurrent wheezing in infants was 0.761(95%CI:0.665-0.857).Conclusion: This study identified family history of asthma,tobacco exposure,and RSV infection as independent risk factors for post-bronchiolitis recurrent wheezing in infants.Based on these three risk factors,the nomogram model has good predictive ability,and it can further screen children with high risk wheezing for clinical.