Long-term prognosis of acute otitis media in infancy: determinants of recurrent acute otitis media and persistent middle ear effusion
Long-term prognosis of acute otitis media in infancy: determinants of recurrent acute otitis media and persistent middle ear effusion
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DOI：
10.1093/fampra/cmi083
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发表时间：
2006-02-01
期刊：
影响因子：
2.2
通讯作者：
de Melker, RA
中科院分区：
文献类型：
--
作者：
Damoiseaux, RAMJ;Rovers, MM;de Melker, RA
目标. 2岁以下儿童急性中耳炎的预后相对较差。本研究的目的是评估儿童期急性中耳炎发作后复发性急性中耳炎和持续性中耳积液的已知决定因素是否也适用于2岁以下儿童。研究设计：对210名2岁以下儿童进行前瞻性研究，确定潜在的预后决定因素。应用单变量和多变量logistic回归分析来评估哪些参数独立有助于预测两种结局指标（复发性急性中耳炎和持续性中耳积液）。建立了预后函数，并以受试者工作特征曲线（ROC）下的面积来估计预后模型的预测能力。人群：2岁以下儿童，在家庭医疗中发生急性中耳炎。结果：复发性急性中耳炎和持续性中耳积液。结果复发性急性中耳炎的数据，从210名儿童和冬季，男性，被动吸烟和持续症状超过10天的介绍是独立的预后决定因素。对于结果，使用了190名儿童的持续性中耳积液数据，冬季，入组时双侧疾病，复发性急性中耳炎的兄弟姐妹病史和既往急性中耳炎发作独立预测结果。没有足够的判别预后模型可以建立任何一个结果的措施。在个别幼儿中复发性急性中耳炎或持续性中耳积液的预测仍然很差。
Objectives. Children under 2 years of age with acute otitis media are known to have a relatively poor prognosis. The objective of this study was to assess whether known determinants for recurrent acute otitis media and persistent middle ear effusion after an episode of acute otitis media during childhood also apply to children under 2 years.Methods. Study design: prospective study of 210 children under 2, with identification of potential prognostic determinants. Univariate and multivariate logistic regression analyses were applied to evaluate which parameters independently contributed to the prediction of both outcome measures (recurrent acute otitis media and persistent middle ear effusion). A prognostic function was developed, and the area under the receiving operating characteristic (ROC) was used to estimate the predictive ability of the prognostic models. Population: children under 2 years of age with an episode of acute otitis media in family practice. Outcomes measured: recurrent acute otitis media and persistent middle ear effusion.Results. For the outcome recurrent acute otitis media data from 210 children were used and winter season, male sex, passive smoking and persistent symptoms for more than 10 days at presentation were independent prognostic determinants. For the outcome persistent middle ear effusion data from 190 children were used and winter season, bilateral disease at entry, a sibling history of recurrent acute otitis media, and a previous episode of acute otitis media independently predicted the outcome. No sufficiently discriminatory prognostic model could be constructed for either outcome measure.Conclusion. Prediction of recurrent acute otitis media or persistent middle ear effusion in individual young children remains poor.