| Objective:To investigate the clinical characteristics and risk factors for rehospitalization of children with bronchopulmonary dysplasia(BPD)due to lower respiratory tract infection within 2 years of age.Method:The clinical data and follow-up information of premature infants with BPD diagnosed at the First Hospital of Jilin University from June 2018 to June 2020 were retrospectively analyzed.The children were classified as mild BPD group,moderate BPD group and severe BPD group according to the degree of BPD,and the rehospitalization of the children in the three groups were compared.The risk factors for their rehospitalization were analyzed by logistic regression.Result:1.A total of 177 children with BPD were enrolled in this study,including 68(38.4%)cases in mild BPD group,36(20.3%)cases in moderate BPD group,73(41.2%)cases in severe BPD group,102 males(57.6%)and 75 females(42.4%).The gestational age ranged from 22.57 to 36.71 weeks,with an average gestational age of 28.81 ±2.00 weeks.Birth weight ranged from 700 to 2770 g,and the median birth weight was 1135(980,1400)g.The lower the gestational age and birth weight of the infants,and the more severe the degree of BPD,the difference was statistically significant(P < 0.01).The more sever the degree of BPD,the longer the time of hospitalization,oxygen and mechanical ventilation,the difference was statistically significant(P < 0.001),but there was no significant difference in gender and mode of delivery among the three groups.(P>0.05).2.Within the first 2 years of life,the rehospitalization rate of 177 children with BPD due to lower respiratory tract infection was 33.3%(59/177).The rehospitalization rates in the mild,moderate and severe groups were 25.0%(17/68),11.1%(4/36)and 52.1%(38/73),respectively.The rehospitalization rates in severe BPD group and times of rehospitalization was more than that in mild and moderate group,which had statistically difference(P < 0.05),and the rehospitalization age was more common in infants within 1 year of age.3.In the follow-up in our hospital,74 children with BPD were readmitted because of lower respiratory tract infection.Symptoms included cough in 67 cases(90.5%),wheezing in 50 cases(67.6%),fever in 18 cases(24.3%),dyspnea in 6 cases(8.1%),and cyanosis in 1 cases(1.4%).Lung signs,lung auscultation could hear wet rales in 62 cases(83.8%),wheezing in 46cases(62.2%).Seven respiratory viruses antigen detection suggested respiratory syncytial virus in 55.9%(19/34).In diagnosis,there were 2 cases of bronchitis(2.7%)and 72 cases of pneumonia(97.3%),including 23 cases of severe pneumonia(31.1%)and 17 cases of severe pneumonia in severe BPD group.The duration of hospital readmission was longer in the severe BPD group,the median time of readmission was 12 days,25 cases used respiratory support,and 13 cases in the intensive care unit.There was no statistically significant differences compared with the mild to moderate BPD group(P>0.05).4.Multivariate logistic regression analysis showed that severe BPD,cytomegalovirus infection in the neonatal period,preterm premature rupture of membranes and personal history of allergy were independent risk factors for rehospitalization of children with BPD due to lower respiratory tract infection.Conclusion:1.Children in the severe BPD group had a high rate of rehospitalization for lower respiratory tract infections and sever disease within 2 years of age.They had a high proportion of readmitted children with wheezing and more RSV infections.2.Severe BPD,cytomegalovirus infection in the neonatal period,premature rupture of membranes,and personal history of allergies are risk factors for readmission of children with BPD for lower respiratory tract infections.Our analysis of risk factors for rehospitalization due to lower respiratory tract infections in children with BPD could be helpful for disease prevention,and further long-term follow-up of children with this disease is needed. |
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