Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis
BackgroundPost-infectious bronchiolitis obliterans (PIBO) is a long-term sequela after an initial insult to the lower respiratory tract. A comprehensive understanding of the factors that contribute to a high risk of developing PIBO is important to help define therapeutic strategies and improve progn...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-06-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.881908/full |
| _version_ | 1818238704496410624 |
|---|---|
| author | Die Liu Jing Liu Jing Liu Lipeng Zhang Lipeng Zhang Yuanmei Chen Qi Zhang |
| author_facet | Die Liu Jing Liu Jing Liu Lipeng Zhang Lipeng Zhang Yuanmei Chen Qi Zhang |
| author_sort | Die Liu |
| collection | DOAJ |
| description | BackgroundPost-infectious bronchiolitis obliterans (PIBO) is a long-term sequela after an initial insult to the lower respiratory tract. A comprehensive understanding of the factors that contribute to a high risk of developing PIBO is important to help define therapeutic strategies and improve prognosis.MethodsWe performed a systematic review of published literature available in the online databases including PubMed, Embase, Web of Science, CNKI, Wan Fang, and VIP, with the last search updated on 27 January 2022. Observational studies and case-control studies that provide sufficient data to examine associations between potential risk factors and PIBO were included. Pooled odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI) and heterogeneity were calculated.ResultsA total of 14 risk factors were selected from 9 studies included in the analysis. The strongest risk factors were hypoxemia, mechanical ventilation, tachypnea, and wheezing. Hypoxemia conferred the greatest risk with pooled OR of 21.54 (95% CI: 10–46.36, p < 0.001). Mechanical ventilation ranked second (pooled OR 14.61, 95% CI: 7.53–28.35, p < 0.001). Use of γ-globulin, use of glucocorticoids, co-infection of bacteria, a history of wheezing, and being male were other prominent risk factors. The effects of premature birth, allergic rhinitis, and imaging finding (pulmonary consolidation, atelectasis, pleural effusion) are less clear and require further confirmation. Cases that developing PIBO had a lower age compared with controls (MD, −8.76 months, 95% CI: −16.50 to −1.02, p = 0.03). No significant differences were observed in the duration of fever (MD, 1.74 days, 95% CI: −0.07 to 3.54, p = 0.06). Children diagnosed with PIBO had higher LDH levels (MD, 264.69 U/L, 95% CI: 67.43 to 461.74, p = 0.008) and duration of hospitalization (MD, 4.50 days, 95% CI: 2.63 to 6.37, p < 0.001).ConclusionIn this study, we found that the strongest risk factors for PIBO were hypoxemia, mechanical ventilation, tachypnea, and wheezing. Use of glucocorticoids, γ-globulin, co-infection of bacteria, a history of wheezing, and being male may also play a role. The factors discussed above can inform the generation of a clinical prediction model for the developing PIBO in children. |
| first_indexed | 2024-12-12T12:45:53Z |
| format | Article |
| id | doaj.art-dc03b7fc3db74620b6c0bd2d50443357 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-12T12:45:53Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-dc03b7fc3db74620b6c0bd2d504433572022-12-22T00:24:07ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-06-011010.3389/fped.2022.881908881908Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-AnalysisDie Liu0Jing Liu1Jing Liu2Lipeng Zhang3Lipeng Zhang4Yuanmei Chen5Qi Zhang6Department of Pediatrics, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pediatrics, China-Japan Friendship Hospital, Beijing, ChinaGraduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Pediatrics, China-Japan Friendship Hospital, Beijing, ChinaGraduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Pediatrics, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pediatrics, China-Japan Friendship Hospital, Beijing, ChinaBackgroundPost-infectious bronchiolitis obliterans (PIBO) is a long-term sequela after an initial insult to the lower respiratory tract. A comprehensive understanding of the factors that contribute to a high risk of developing PIBO is important to help define therapeutic strategies and improve prognosis.MethodsWe performed a systematic review of published literature available in the online databases including PubMed, Embase, Web of Science, CNKI, Wan Fang, and VIP, with the last search updated on 27 January 2022. Observational studies and case-control studies that provide sufficient data to examine associations between potential risk factors and PIBO were included. Pooled odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI) and heterogeneity were calculated.ResultsA total of 14 risk factors were selected from 9 studies included in the analysis. The strongest risk factors were hypoxemia, mechanical ventilation, tachypnea, and wheezing. Hypoxemia conferred the greatest risk with pooled OR of 21.54 (95% CI: 10–46.36, p < 0.001). Mechanical ventilation ranked second (pooled OR 14.61, 95% CI: 7.53–28.35, p < 0.001). Use of γ-globulin, use of glucocorticoids, co-infection of bacteria, a history of wheezing, and being male were other prominent risk factors. The effects of premature birth, allergic rhinitis, and imaging finding (pulmonary consolidation, atelectasis, pleural effusion) are less clear and require further confirmation. Cases that developing PIBO had a lower age compared with controls (MD, −8.76 months, 95% CI: −16.50 to −1.02, p = 0.03). No significant differences were observed in the duration of fever (MD, 1.74 days, 95% CI: −0.07 to 3.54, p = 0.06). Children diagnosed with PIBO had higher LDH levels (MD, 264.69 U/L, 95% CI: 67.43 to 461.74, p = 0.008) and duration of hospitalization (MD, 4.50 days, 95% CI: 2.63 to 6.37, p < 0.001).ConclusionIn this study, we found that the strongest risk factors for PIBO were hypoxemia, mechanical ventilation, tachypnea, and wheezing. Use of glucocorticoids, γ-globulin, co-infection of bacteria, a history of wheezing, and being male may also play a role. The factors discussed above can inform the generation of a clinical prediction model for the developing PIBO in children.https://www.frontiersin.org/articles/10.3389/fped.2022.881908/fullmeta-analysispost-infectious bronchiolitis obliteransbronchiolitis obliteransrisk factorschildren |
| spellingShingle | Die Liu Jing Liu Jing Liu Lipeng Zhang Lipeng Zhang Yuanmei Chen Qi Zhang Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis Frontiers in Pediatrics meta-analysis post-infectious bronchiolitis obliterans bronchiolitis obliterans risk factors children |
| title | Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis |
| title_full | Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis |
| title_fullStr | Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis |
| title_short | Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis |
| title_sort | risk factors for post infectious bronchiolitis obliterans in children a systematic review and meta analysis |
| topic | meta-analysis post-infectious bronchiolitis obliterans bronchiolitis obliterans risk factors children |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.881908/full |
| work_keys_str_mv | AT dieliu riskfactorsforpostinfectiousbronchiolitisobliteransinchildrenasystematicreviewandmetaanalysis AT jingliu riskfactorsforpostinfectiousbronchiolitisobliteransinchildrenasystematicreviewandmetaanalysis AT jingliu riskfactorsforpostinfectiousbronchiolitisobliteransinchildrenasystematicreviewandmetaanalysis AT lipengzhang riskfactorsforpostinfectiousbronchiolitisobliteransinchildrenasystematicreviewandmetaanalysis AT lipengzhang riskfactorsforpostinfectiousbronchiolitisobliteransinchildrenasystematicreviewandmetaanalysis AT yuanmeichen riskfactorsforpostinfectiousbronchiolitisobliteransinchildrenasystematicreviewandmetaanalysis AT qizhang riskfactorsforpostinfectiousbronchiolitisobliteransinchildrenasystematicreviewandmetaanalysis |