Back to Search
Start Over
Diagnosis in children with exercise-induced respiratory symptoms: A multi-center study.
- Source :
-
Pediatric pulmonology [Pediatr Pulmonol] 2021 Jan; Vol. 56 (1), pp. 217-225. Date of Electronic Publication: 2020 Nov 17. - Publication Year :
- 2021
-
Abstract
- Objective: Exercise-induced respiratory symptoms (EIS) are common in childhood and reflect different diseases that can be difficult to diagnose. In children referred to respiratory outpatient clinics for EIS, we compared the diagnosis proposed by the primary care physician with the final diagnosis from the outpatient clinic and described diagnostic tests and treatments.<br />Design: An observational study of respiratory outpatients aged 0-16 years nested in the Swiss Paediatric Airway Cohort (SPAC).<br />Patients: We included children with EIS as the main reason for referral. Information about diagnostic investigations, final diagnosis, and treatment prescribed came from outpatient records. We included 214 children (mean age 12 years, range 2-17, 54% males) referred for EIS.<br />Results: The final diagnosis was asthma in 115 (54%), extrathoracic dysfunctional breathing (DB) in 35 (16%), thoracic DB in 22 (10%), asthma plus DB in 23 (11%), insufficient fitness in 10 (5%), chronic cough in 6 (3%), and other diagnoses in 3 (1%). Final diagnosis differed from referral diagnosis in 115 (54%, 95%-CI 46%-60%). Spirometry, body plethysmography, and exhaled nitric oxide were performed in almost all, exercise-challenge tests in a third, and laryngoscopy in none. 91% of the children with a final diagnosis of asthma were prescribed inhaled medication and 50% of children with DB were referred to physiotherapy.<br />Conclusions: Diagnosis given at the outpatient clinic often differed from the diagnosis proposed by the referring physician. Diagnostic evaluations, management, and follow-up differed between clinics and diagnostic groups highlighting the need for evidence-based diagnostic guidelines and harmonized procedures for children seen for EIS.<br /> (© 2020 Wiley Periodicals LLC.)
- Subjects :
- Adolescent
Breath Tests
Bronchial Provocation Tests
Child
Child, Preschool
Cough diagnosis
Cough etiology
Exercise Test
Female
Humans
Infant
Infant, Newborn
Male
Nitric Oxide analysis
Physical Fitness
Respiration Disorders diagnosis
Spirometry methods
Switzerland
Asthma, Exercise-Induced diagnosis
Respiratory Function Tests
Subjects
Details
- Language :
- English
- ISSN :
- 1099-0496
- Volume :
- 56
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Pediatric pulmonology
- Publication Type :
- Academic Journal
- Accession number :
- 33079473
- Full Text :
- https://doi.org/10.1002/ppul.25126