title: Hypoxemia is an independent predictor of bronchiolitis obliterans following respiratory adenoviral infection in children.
abstract: Bronchiolitis obliterans (BO) is an uncommon and severe sequela of chronic obstructive lung disease in children that results from an insult to the lower respiratory tract. Few prognostic factors achieved worldwide acknowledgment. In the present study, we retrospectively collected the children with respiratory adenoviral infection and identified the predictive factors of BO. In the period between Jan 2011 and December 2014, the consecutive in-hospital acute respiratory infection children with positive result for adenovirus were enrolled into the present study. High resolution computerized tomography and clinical symptoms were utilized as the diagnostic technique for BO. Multivariate analysis using a Logistic proportional hazards model was used to test for independent predictors of BO. A total of 544 children were included with 14 (2.57 %) patients developed BO. Compared with children without BO, BO children presented higher LDH (523.5 vs. 348 IU/ml,p= 0.033), lower blood lymphocyte count (2.23 × 109/L vs. 3.24 × 109/L,p= 0.025) and higher incidence of hypoxemia (78.6 vs. 20.8 %,p= 0.000). They presented relatively persistent fever (15.5 vs. 7 days,p= 0.000) and needed longer treatment in hospital (19.5 vs. 7 days,p= 0.000). Concerning treatment, they were given more intravenous γ-globulin (85.7 vs. 36.8 %,p= 0.000), glucocorticoids (78.6 vs. 24.3 %,p= 0.000) and mechanical ventilation (35.7 vs. 5.5 %,p= 0.001). Multiple analyses determined that hypoxemia was the only independent predictor for BO. The present study identified hypoxemia as the independent predictive factor of BO in adenoviral infected children, which was a novel and sensitive predictor for BO.
authors.affiliation: Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623 People's Republic of China.
authors.forename: Pei-Qiong
authors.initials: PQ
authors.lastname: Wu
authors.affiliation: Institute of Human Virology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080 People's Republic of China.|Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630 People's Republic of China.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623 People's Republic of China.
authors.forename: Wen-Hui
authors.initials: WH
authors.lastname: Jiang
authors.affiliation: Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623 People's Republic of China.
authors.forename: Gen-Quan
authors.initials: GQ
authors.lastname: Yin
authors.affiliation: Institute of Human Virology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080 People's Republic of China.
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Lei
authors.affiliation: Institute of Human Virology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080 People's Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xiao
authors.affiliation: Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623 People's Republic of China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Huang
authors.affiliation: Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623 People's Republic of China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Xie
authors.affiliation: Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623 People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Deng
keywords: Adenovirus; Bronchiolitis obliterans; Hypoxemia; Respiratory infection