title: Prognosis of acute otitis media: factors associated with poor outcome.
abstract: Factors associated with poor outcome of acute otitis media (AOM) were analysed in 131 children aged 1/4 to 7 1/2 (median 2 1/2) years. After AOM, altogether 37 (28%) of the children had poor outcome: 15 children (12%) clinical failure (unimprovement or worsening of pre-treatment signs and symptoms within 2 weeks of onset of therapy) and 31 (24%) persistent middle ear effusion (MEE) > or = 1 month post-treatment. Of the different variables studied in multivariate analysis, age < 2 years (p < 0.01), history of allergic skin or respiratory symptoms (p = 0.02), > or = 6 h duration of pre-treatment earache (p = 0.01) and B. catarrhalis in MEE (p = 0.05) were associated with clinical failure. Children with previous adenotomy or unilateral AOM had no failures. Persistence of MEE at 1 month was associated with age < 2 years (p = 0.05), otitis proneness (p = 0.03), bilaterality of AOM (p < 0.01) and S. pneumoniae in MEE (p = 0.01) in univariate but not in multivariate analysis.
authors.affiliation: Department of Otolaryngology, Helsinki University Central Hospital, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Jero
authors.forename: A
authors.initials: A
authors.lastname: Virolainen
authors.forename: M
authors.initials: M
authors.lastname: Virtanen
authors.forename: J
authors.initials: J
authors.lastname: Eskola
authors.forename: P
authors.initials: P
authors.lastname: Karma
mesh_terms: D000208:Acute Disease; D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D008297:Male; D015999:Multivariate Analysis; D010034:Otitis Media with Effusion / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011379:Prognosis; D012307:Risk Factors; D017211:Treatment Failure