Retrospective assessment of changes in bronchial obstruction severity interpretation in children according to new recommendations

Le résumé fourni par la source

Rationale: High FEV1 values in children and low cut-offs proposed in the new recommendations for interpreting the severity of bronchial obstruction could result in nearly no severe FEV1 impairment in children. Objective: To test the relevance of a three-level system to grade bronchial obstruction in children. Methods: Retrospective study in children with bronchial diseases or symptoms who performed a spirometry during 2021 in our department to compare the previous classification based on five levels of severity according to FEV1 z-score (Quanjer ERJ 2014) to the recent one (Stanojevic ERJ 2021). Results: We retrieved 1889 files (1458 tested for asthma) from 1624 children (mean (SD) age 11.8 (3.4) y, 602 (37%) females) of which 426 (22.6%) showed baseline bronchial obstruction on FEV1/FVC z-score < -1.645. A majority of obstructed patterns displayed normal FEV1 z-score (≥ -1.645 z-score, n=245, 57.5%). There were less mild but more very/severe obstruction using the five-level classification compared to the three-level classification (Table). Conclusions: Using a three-level system to interpret spirometry in children would result in nearly no severe impairment (3.3%) compared to using the previous five-level classification (10.3%). This finding goes along the quasi absence of mortality from bronchial disease at paediatric age.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.