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Article Dans Une Revue Thorax Année : 2016

A clustering approach to identify severe bronchiolitis profiles in children

Résumé

Objective Although bronchiolitis is generally considered a single disease, recent studies suggest heterogeneity. We aimed to identify severe bronchiolitis profiles using a clustering approach. Methods We analysed data from two prospective, multicentre cohorts of children younger than 2 years hospitalised with bronchiolitis, one in the USA (2007' 2010 winter seasons, n=2207) and one in Finland (2008'2010 winter seasons, n=408). Severe bronchiolitis profiles were determined by latent class analysis, classifying children based on clinical factors and viral aetiology. Results In the US study, four profiles were identified. Profile A (12%) was characterised by history of wheezing and eczema, wheezing at the emergency department (ED) presentation and rhinovirus infection. Profile B (36%) included children with wheezing at the ED presentation, but, in contrast to profile A, most did not have history of wheezing or eczema; this profile had the largest probability of respiratory syncytial virus infection. Profile C (34%) was the most severely ill group, with longer hospital stay and moderate-to-severe retractions. Profile D (17%) had the least severe illness, including non-wheezing children with shorter length of stay. Two of these profiles (A and D) were replicated in the Finnish cohort; a third group ('BC') included Finnish children with characteristics of profiles B and/or C in the US population. Conclusions Several distinct clinical profiles (phenotypes) were identified by a clustering approach in two multicentre studies of children hospitalised for bronchiolitis. The observed heterogeneity has important implications for future research on the aetiology, management and long-term outcomes of bronchiolitis, such as future risk of childhood asthma.
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inserm-04455063 , version 1 (13-02-2024)

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Orianne Dumas, Jonathan M. Mansbach, Tuomas Jartti, Kohei Hasegawa, Ashley F. Sullivan, et al.. A clustering approach to identify severe bronchiolitis profiles in children. Thorax, 2016, 71 (8), pp.712-8. ⟨10.1136/thoraxjnl-2016-208535⟩. ⟨inserm-04455063⟩
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