Respiratory outcome of infants with or without documented wheezing during bronchiolitis

ABSTRACT
The presence of wheezing during bronchiolitis may be associated with recurrent episodes of wheezing and asthma.
The objectives were to assess the inter-observer agreement of wheezing recorded by a digital stethoscope during a bronchiolitis and to assess whether the identification of wheezing was associated with an increased incidence of recurrent wheezing at three years and asthma at six years.
Two hundred and seventy infants (<2 years) with bronchiolitis were included, while follow-up data at 3 and 6 years were available for 144 (33 had definite wheezing during bronchiolitis: 23%) and 112 (28 had definite wheezing during their bronchiolitis: 25%) children, respectively.
The overall agreement percentage between the two raters for wheezing (249 infants were available for the two raters) was 71%, with a free-marginal kappa of 0.42 (95% CI [0.31, 0.53]), which is a moderate agreement. The prevalence of definite (two observers) wheezing was 58/270 (21%) that was associated with tobacco exposure and, at 3 years of age, with more respiratory episodes and asthma medications while it was not associated with asthma at 6 years.
In conclusion, the agreement over wheezing during bronchiolitis is moderate, but it ought to be diagnosed since it is associated with recurrent respiratory episodes (wheezing).

IMPACT STATEMENT
The formal identification of wheezing during a bronchiolitis episode is associated with recurrent episodes of respiratory episodes.

Received: Oct 09, 2024
Accepted: Feb 28, 2025
Published: Mar 27, 2025