Abstract
Background: a subset of wheezing toddlers will develop asthma. Sensitisation is known to predict asthma among these children in birth cohorts. However, its predictive value among wheezing toddlers in secondary healthcare is uncertain.
Objectives: to determine the prognosis and predictive value of sensitisation to inhalant allergens among wheezing toddlers in secondary healthcare for the development of asthma at school age.
Methods: wheezing toddlers who visited a Dutch hospital were retrospectively analysed. Asthma at school age (≥ six years) was determined through the International Study of Asthma and Allergies in Childhood questionnaire. The predictive value of sensitisation and several non-invasive determinants were calculated. The added predictive value of sensitisation when combined with non-invasive determinants was examined using ROC curves.
Results: of 166 included children, 55% developed asthma at school age. In 116 children specific IgE was measured at preschool age. Within this subgroup, the asthma prevalence was 63%. Sensitisation to inhalant allergens was the strongest predictor of asthma. The OR, positive and negative predictive value were 7.4, 86% and 55%, respectively. Eczema (OR 3.4) and hospital admission (OR 2.6) were statistically significant non-invasive predictors. Adding sensitisation to these variables resulted in a significantly better asthma prediction. The area under the ROC curve increased from 0.696 to 0.793.
Conclusions: the majority of wheezing toddlers in secondary healthcare develops asthma at school age. Sensitisation to inhalant allergens is the strongest predictor of asthma and has added predictive value when combined with non-invasive determinants.
- Copyright ©ERS 2015