Clinical characteristics of plastic bronchitis and risk factors for recurrence in children
TIAN Xiao-Yin, ZHANG Guang-Li, WANG Chong-Jie, GU Rui-Xue, LI Yuan-Yuan, LI Qin-Yuan, LUO Jian, LUO Zheng-Xiu
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
Abstract Objective To study the clinical characteristics of plastic bronchitis (PB) in children and investigate the the risk factors for recurrence of PB. Methods This was a retrospective analysis of medical data of children with PB who were hospitalized in Children's Hospital of Chongqing Medical University from January 2012 to July 2022. The children were divided into a single occurrence of PB group and a recurrent PB group and the risk factors for recurrence of PB were analyzed. Results A total of 107 children with PB were included, including 61 males (57.0%) and 46 females (43.0%), with a median age of 5.0 years, and 78 cases (72.9%) were over 3 years old. All the children had cough, 96 children (89.7%) had fever, with high fever in 90 children. Seventy-three children (68.2%) had shortness of breath, and 64 children (59.8%) had respiratory failure. Sixty-six children (61.7%) had atelectasis and 52 children (48.6%) had pleural effusion. Forty-seven children (43.9%) had Mycoplasma pneumoniae infection, 28 children (26.2%) had adenovirus infection, and 17 children (15.9%) had influenza virus infection. Seventy-one children (66.4%) had a single occurrence of PB, and 36 cases (33.6%) had recurrent occurrence of PB (≥2 times). Multivariate logistic regression analysis showed that involvement of ≥2 lung lobes (OR=3.376) under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts (OR=3.275), and concomitant multi-organ dysfunction outside the lungs (OR=2.906) were independent risk factors for recurrent occurrence of PB (P<0.05). Conclusions Children with pneumonia accompanied by persistent high fever, shortness of breath, respiratory failure, atelectasis or pleural effusion should be highly suspected with PB. Involvement of ≥2 lung lobes under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts, and concomitant multi-organ dysfunction outside the lungs may be risk factors for recurrent occurrence of PB.
Corresponding Authors:
Luo Z-X，E-mail：luozhengxiu816@hospital.cqmu.edu.cn
E-mail: luozhengxiu816@hospital.cqmu.edu.cn
Cite this article:
TIAN Xiao-Yin,ZHANG Guang-Li,WANG Chong-Jie et al. Clinical characteristics of plastic bronchitis and risk factors for recurrence in children[J]. CJCP, 2023, 25(6): 626-632.
TIAN Xiao-Yin,ZHANG Guang-Li,WANG Chong-Jie et al. Clinical characteristics of plastic bronchitis and risk factors for recurrence in children[J]. CJCP, 2023, 25(6): 626-632.
