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School age outcome of respiratory syncytial virus hospitalisation of prematurely born infants
  1. Anne Greenough (anne.greenough{at}kcl.ac.uk)
  1. King's College London, Division of Asthma, Allergy and Lung Biology, United Kingdom
    1. John Alexander (john.alexander{at}uhns.nhs.uk)
    1. North Staffordshire Hospital, United Kingdom
      1. Phillipa Boit (phillipa.boit{at}uhns.nhs.uk)
      1. North Staffordshire Hospital, United Kingdom
        1. Jill Boorman (jill.boorman{at}abbott.com)
        1. Abbott Laboratories, United Kingdom
          1. Sal Burgess (sal.burgess{at}leedsgh.nhs.uk)
          1. Leeds General Infirmary, United Kingdom
            1. Andrew Burke (andrew.burke{at}lwh.nhs.uk)
            1. Liverpool Women's Hospital, United Kingdom
              1. Philip Chetcuti (philip.chetcuti{at}leedsgh.nhs.uk)
              1. Leeds General Infirmary, United Kingdom
                1. Ian Cliff (ian.cliff{at}uhns.nhs.uk)
                1. North Staffordshire Hospital, United Kingdom
                  1. Warren Lenney (wlenney{at}lycos.com)
                  1. North Staffordshire Hospital, United Kingdom
                    1. Thomas Lytle (thomas.lytle{at}abbott.com)
                    1. Abbott Laboratories, United Kingdom
                      1. Colin Morgan (colin.morgan{at}lwh.nhs.uk)
                      1. Liverpool Women's Hospital, United Kingdom
                        1. Clare Raiman (clare.raiman{at}kcl.ac.uk)
                        1. King's College London, Division of Asthma, Allergy and Lung Biology, United Kingdom
                          1. Nigel J Shaw (ben.shaw{at}lwh.nhs.uk)
                          1. Liverpool Women's Hospital, United Kingdom
                            1. Karl P Sylvester (karl.sylvester{at}kcl.ac.uk)
                            1. King's College London, Division of Asthma, Allergy and Lung Biology, United Kingdom
                              1. Jackie Turner (jt{at}turnstat.freeserve.co.uk)
                              1. Premier Research Group plc, United Kingdom

                                Abstract

                                Background: Hospitalisation due to respiratory syncytial virus (RSV) infection in the first two years after birth has been associated with increased healthcare utilisation and associated costs up to five years of age in children born prematurely at less than 32 weeks of gestation who developed bronchopulmonary dysplasia (BPD). We determined whether RSV hospitalisation in the first two years was associated with increased morbidity and lung function abnormalities in such children at school age and if any effects were influenced by age.

                                Methods: Healthcare utilisation and cost of care in years five to seven were reviewed in 147 children and changes in healthcare utilisation between 0 and 8 years were assessed also using results from two previous studies. At aged 8 to 10 years, 77 children had their lung function assessed and bronchial hyper-responsiveness determined.

                                Results: Children with a RSV hospitalisation (n=25) compared to those with a non respiratory or no admission (n=72) in the first two years had a greater cost of care related to outpatient attendance (p=0.0076) when aged five to seven. At 8 to 10 years, “RSV” hospitalisation (n=14) compared to “non RSV” hospitalisation (n=63) children had lower forced expiratory volume in 0.75 seconds (FEV0.75) (p=0.0151), FEV0.75/ forced vital capacity (p=0.0274) and flows at 50% (p=0.0335) and 75% (p=0.0055) of the vital capacity. Healthcare utilisation decreased with increasing age regardless of RSV hospitalisation status.

                                Conclusions: In prematurely born children who had BPD, RSV hospitalisation in the first two years is associated with reduced airway calibre at school age.

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