TY - JOUR
T1 - Impact of Early-Onset Acute Otitis Media on Multiple Recurrences and Associated Health Care Use
AU - de Hoog, Marieke L A
AU - Fortanier, Alexandre C
AU - Smit, Henriette A
AU - Uiterwaal, Cuno S P M
AU - van der Ent, Cornelis K
AU - Schilder, Anne
AU - Damoiseaux, Roger A M J
AU - Venekamp, Roderick P
AU - Bruijning-Verhagen, Patricia
N1 - Copyright © 2016 Elsevier Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - OBJECTIVE: To quantify the critical age period of first episode of acute otitis media (AOM) and its consequences for AOM recurrences and AOM health care use.STUDY DESIGN: Children enrolled in the Wheezing-Illnesses-STudy-LEidsche-Rijn cohort with at least 1 episode of AOM documented in their primary care health record before 2 years of age were followed until 6 years of age. Data on episodes of AOM and associated primary care consultations, antibiotic prescriptions, and specialist referrals were retrieved. Regression models assessed the presence and shape of the associations between age of first AOM and subsequent episodes of AOM and health care use.RESULTS: A total of 796 of 2026 children (39%) experienced a first AOM before 2 years of age. Each month decrease in age at first AOM in the first 2 years of life increased the risk of developing recurrent AOM (≥3 AOM episodes in 6 months or ≥ 4 in 1 year) linearly by 6% (adjusted risk ratio: 1.06; 95% CI: 1.02-1.10). For first AOM occurring before 9 months, the cumulative 6-year primary care consultation rate increased by 8% (adjusted incidence rate ratio: 1.08; 95% CI: 1.03-1.15) and the associated specialist referral increased by 16% (adjusted risk ratio: 1.16; 95% CI: 1.07-1.27) for each month decrease in age. No associations were found between age at first AOM and total AOM episodes or antibiotic prescriptions.CONCLUSIONS: The association between earlier age of first AOM and recurrent AOM as well as total health care use during childhood is particularly strong before 9 months of age.
AB - OBJECTIVE: To quantify the critical age period of first episode of acute otitis media (AOM) and its consequences for AOM recurrences and AOM health care use.STUDY DESIGN: Children enrolled in the Wheezing-Illnesses-STudy-LEidsche-Rijn cohort with at least 1 episode of AOM documented in their primary care health record before 2 years of age were followed until 6 years of age. Data on episodes of AOM and associated primary care consultations, antibiotic prescriptions, and specialist referrals were retrieved. Regression models assessed the presence and shape of the associations between age of first AOM and subsequent episodes of AOM and health care use.RESULTS: A total of 796 of 2026 children (39%) experienced a first AOM before 2 years of age. Each month decrease in age at first AOM in the first 2 years of life increased the risk of developing recurrent AOM (≥3 AOM episodes in 6 months or ≥ 4 in 1 year) linearly by 6% (adjusted risk ratio: 1.06; 95% CI: 1.02-1.10). For first AOM occurring before 9 months, the cumulative 6-year primary care consultation rate increased by 8% (adjusted incidence rate ratio: 1.08; 95% CI: 1.03-1.15) and the associated specialist referral increased by 16% (adjusted risk ratio: 1.16; 95% CI: 1.07-1.27) for each month decrease in age. No associations were found between age at first AOM and total AOM episodes or antibiotic prescriptions.CONCLUSIONS: The association between earlier age of first AOM and recurrent AOM as well as total health care use during childhood is particularly strong before 9 months of age.
KW - childhood
KW - early onset
KW - health care use
KW - cohort study
UR - http://www.scopus.com/inward/record.url?scp=84999886493&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2016.06.066
DO - 10.1016/j.jpeds.2016.06.066
M3 - Article
C2 - 27499216
SN - 0022-3476
VL - 177
SP - 286-291.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -