title: Predictors of chronic suppurative otitis media in children.
abstract: OBJECTIVE
  To determine which factors predict development of chronic suppurative otitis media (CSOM) in children.
  
  
  METHODS
  Case-control study, with univariate and multivariate logistic regression analysis applied to determine which factors independently predict CSOM.
  
  
  METHODS
  Prognostic factors for CSOM were identified in (1) 100 children with CSOM and 161 controls aged 1 to 12 years and (2) 83 children who developed CSOM in the presence of a tympanostomy tube and 136 children with tympanostomy tubes who did not develop CSOM.
  
  
  RESULTS
  Independent predictors for CSOM were previous tympanostomy tube insertion (odds ratio [OR], 121.4 [95% confidence interval {CI}, 38.9-379.3]); having had more than 3 upper respiratory tract infections in the past 6 months (OR, 12.2 [95% CI, 3.5-42.3]); having parents with a low education level (OR, 14.1 [95% CI, 2.9-68.6]); and having older siblings (OR, 4.4 [95% CI, 1.6-12.6]). Independent predictors for CSOM after tympanostomy tube insertion were having experienced more than 3 episodes of otitis media in the past year (OR, 4.9 [95% CI, 2.2-11.0]; attending day care (OR, 3.6 [95% CI, 1.7-7.8]); and having older siblings (OR, 2.6 [95% CI, 1.2-5.5]).
  
  
  CONCLUSIONS
  Treatment with tympanostomy tubes is the most important prognostic factor for CSOM in children. In children who are being treated with tympanostomy tubes for persistent middle ear effusion, the most important prognostic factor for CSOM is a history of recurrent episodes of acute otitis media. This information should be taken into consideration and discussed with parents when considering insertion of tympanostomy tubes in children.
authors.affiliation: Department of Otorhinolaryngology, Wilhelmina Children's Hospital, and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. E.L.vanderVeen@umcutrecht.nl
authors.forename: Erwin L
authors.initials: EL
authors.lastname: van der Veen
authors.forename: Anne G M
authors.initials: AG
authors.lastname: Schilder
authors.forename: Niels
authors.initials: N
authors.lastname: van Heerbeek
authors.forename: Monique
authors.initials: M
authors.lastname: Verhoeff
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Zielhuis
authors.forename: Maroeska M
authors.initials: MM
authors.lastname: Rovers
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D010035:Otitis Media, Suppurative / Q000209:etiology* / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D012959:Socioeconomic Factors