Latent class analysis to identify clinical profiles among indigenous infants with bronchiolitis

Hongqi Niu; Anne Berndette Chang; Victor Maduabuchi Oguoma; Zhiqiang Wang; Gabrielle Britt McCallum

doi:10.1002/ppul.25044

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Latent class analysis to identify clinical profiles among indigenous infants with bronchiolitis

Journal article

Peer reviewed

Latent class analysis to identify clinical profiles among indigenous infants with bronchiolitis

Hongqi Niu, Anne Berndette Chang, Victor Maduabuchi Oguoma, Zhiqiang Wang and Gabrielle Britt McCallum

Pediatric Pulmonology, Vol.55(11), pp.3096-3103

2020

DOI: https://doi.org/10.1002/ppul.25044

PMID: 32845576

Abstract

bronchiectasis

bronchiolitis

hospitalization

Indigenous

latent class analysis

Objective: Better phenotyping of the heterogenous bronchiolitis syndrome may lead to targeted future interventions. This study aims to identify severe bronchiolitis profiles among hospitalized Australian Indigenous infants, a population at risk of bronchiectasis, using latent class analysis (LCA). Methods: We included prospectively collected clinical, viral, and nasopharyngeal bacteria data from 164 Indigenous infants hospitalized with bronchiolitis from our previous studies. We undertook multiple correspondence analysis (MCA) followed by LCA. The best-fitting model for LCA was based on adjusted Bayesian information criteria and entropy R2. Results: We identified five clinical profiles. Profile-A's (23.8% of cohort) phenotype was previous preterm (90.7%), low birth-weight (89.2%) and weight-for-length z-score <−1 (82.7% from combining those with z-score between −1 and −2 and those in the z-score of <−2 group) previous respiratory hospitalization (39.6%) and bronchiectasis on chest high-resolution computed tomography scan (35.4%). Profile-B (25.3%) was characterized by the oxygen requirement (100%) and marked accessory muscle use (45.5%). Infants in profile-C (7.0%) had the most severe disease, with oxygen requirement and bronchiectasis in 100%, moderate accessory muscle use (85% vs 0%-51.4%) and bacteria detected (93.1% vs 56.7%-72.0%). Profile-D (11.6%) was dominated by rhinovirus (49.4%), mild accessory muscle use (73.8%), and weight-for-length z-score <−2 (36.0%). Profile-E (32.2%) included bronchiectasis (13.8%), RSV (44.0%), rhinovirus (26.3%) and any bacteria (72%). Conclusion: Using LCA in Indigenous infants with severe bronchiolitis, we identified five clinical profiles with one distinct profile for bronchiectasis. LCA can characterize distinct phenotypes for severe bronchiolitis and infants at risk for future bronchiectasis, which may inform future targeted interventions.

Details

Title: Latent class analysis to identify clinical profiles among indigenous infants with bronchiolitis
Authors: Hongqi Niu (Corresponding Author) - Menzies School of Health Research
Anne Berndette Chang - Menzies School of Health Research
Victor Maduabuchi Oguoma (Author) - Menzies School of Health Research
Zhiqiang Wang (Author) - Menzies School of Health Research
Gabrielle Britt McCallum (Author) - Menzies School of Health Research
Publication details: Pediatric Pulmonology, Vol.55(11), pp.3096-3103
Publisher: John Wiley & Sons, Inc.
Date published: 2020
DOI: 10.1002/ppul.25044
ISSN: 1099-0496
PMID: 32845576
Grants: Improving lung health of Indigenous children, through identifying interventional targets from long term follow-up studies and preventive strategies, 1111705, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Improving children's respiratory health through better evidence and knowledge, 1058213, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Grant note: HN is supported by a Research Training Program (RTP) Fees Offset and Stipend Scholarship from the Australian Commonwealth Government; and Queensland Children's Hospital Foundation (50286)
Organisation Unit: Thompson Institute
Language: English
Record Identifier: 991121851302621
Output Type: Journal article