Unplanned, Postoperative Intubation in Pediatric Surgical Patients

2016 ◽  
Vol 125 (5) ◽  
pp. 914-928 ◽  
Author(s):  
Eric C. Cheon ◽  
Hannah L. Palac ◽  
Kristine H. Paik ◽  
John Hajduk ◽  
Gildasio S. De Oliveira ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Pediatric Patients ◽  
Postoperative Mortality ◽  
Operation Time ◽  
Noncardiac Surgery ◽  
Improvement Program ◽  
Physical Status Classification ◽  
Increased Risk

Abstract Background To date, the independent predictors and outcomes of unplanned postoperative intubation (UPI) in pediatric patients after noncardiac surgery are yet to be characterized. The authors aimed to identify the incidence and predictors of this event and evaluated the effect of this event on postoperative mortality. Methods Data of 87,920 patients from the American College of Surgeons National Surgical Quality Improvement Program Pediatric database were analyzed and assigned to derivation (n = 58,614; 66.7%) or validation (n = 29,306; 33.3%) cohorts. The derivation cohort was analyzed for the incidence and independent predictors of early UPI. The final multivariable logistic regression model was validated using the validation cohort. Results Early UPI occurred with an incidence of 0.2% in both cohorts. Among the 540 patients who experienced a UPI, 178 (33.0%) were intubated within the first 72 h after surgery. The final logistic regression model indicated operation time, severe cardiac risk factors, American Society of Anesthesiologists physical status classification more than or equal to 2, tumor involving the central nervous system, developmental delay/impaired cognitive function, past or current malignancy, and neonate status as independent predictors of early UPI. Having an early UPI was associated with an increased risk of unadjusted, all-cause 30-day mortality, demonstrating an odds ratio of 11.4 (95% CI, 5.8 to 22.4). Conclusions Pediatric patients who experienced an early UPI after noncardiac surgery had an increased likelihood of unadjusted 30-day mortality by more than 11-fold. Identification of high-risk patients can allow for targeted intervention and potential prevention of such outcomes.

scholarly journals Long Noncoding RNA THAP9-AS1 and TSPOAP1-AS1 Provide Potential Diagnostic Signatures for Pediatric Septic Shock

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yong Wu ◽  
Qigai Yin ◽  
Xiaobao Zhang ◽  
Pin Zhu ◽  
Hengfei Luan ◽  
...  
Keyword(s):  
Septic Shock ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Pediatric Patients ◽  
R Package ◽  
Differentially Expressed ◽  
Blood Samples ◽  
Health Control ◽  
Control Samples

Background. Sepsis is a systemic inflammatory syndrome caused by infection with a high incidence and mortality. Although long noncoding RNAs have been identified to be closely involved in many inflammatory diseases, little is known about the role of lncRNAs in pediatric septic shock. Methods. We downloaded the mRNA profiles GSE13904 and GSE4607, of which GSE13904 includes 106 blood samples of pediatric patients with septic shock and 18 health control samples; GSE4607 includes 69 blood samples of pediatric patients with septic shock and 15 health control samples. The differentially expressed lncRNAs were identified through the limma R package; meanwhile, GO terms and KEGG pathway enrichment analysis was performed via the clusterProfiler R package. The protein-protein interaction (PPI) network was constructed based on the STRING database using the targets of differently expressed lncRNAs. The MCODE plug-in of Cytoscape was used to screen significant clustering modules composed of key genes. Finally, stepwise regression analysis was performed to screen the optimal lncRNAs and construct the logistic regression model, and the ROC curve was applied to evaluate the accuracy of the model. Results. A total of 13 lncRNAs which simultaneously exhibited significant differences in the septic shock group compared with the control group from two sets were identified. According to the 18 targets of differentially expressed lncRNAs, we identified some inflammatory and immune response-related pathways. In addition, several target mRNAs were predicted to be potentially involved in the occurrence of septic shock. The logistic regression model constructed based on two optimal lncRNAs THAP9-AS1 and TSPOAP1-AS1 could efficiently separate samples with septic shock from normal controls. Conclusion. In summary, a predictive model based on the lncRNAs THAP9-AS1 and TSPOAP1-AS1 provided novel lightings on diagnostic research of septic shock.

Surgical Site Infection in a Tertiary Neonatal Surgery Centre

2018 ◽  
Vol 29 (03) ◽  
pp. 260-265 ◽  
Author(s):  
Adiam Woldemicael ◽  
Sarah Bradley ◽  
Caroline Pardy ◽  
Justin Richards ◽  
Paolo Trerotoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Model ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Logistic Regression Model ◽  
Length Of Hospital Stay ◽  
Neonatal Surgery ◽  
Site Infection ◽  
Increased Risk

Introduction Surgical site infection (SSI) is a key performance indicator to assess the quality of surgical care. Incidence and risk factors for SSI in neonatal surgery are lacking in the literature. Aim To define the incidence of SSI and possible risk factors in a tertiary neonatal surgery centre. Materials and Methods This is a prospective cohort study of all the neonates who underwent abdominal and thoracic surgery between March 2012 and October 2016. The variables analyzed were gender, gestational age, birth weight, age at surgery, preoperative stay in neonatal intensive care unit, type of surgery, length of stay, and microorganisms isolated from the wounds. Statistical analysis was done with chi-square, Student's t- or Mann–Whitney U-tests. A logistic regression model was used to evaluate determinants of risk for SSI; variables were analyzed both with univariate and multivariate models. For the length of hospital stay, a logistic regression model was performed with independent variables. Results A total of 244 neonates underwent 319 surgical procedures. The overall incidence of SSIs was 43/319 (13.5%). The only statistical differences between neonates with and without SSI were preoperative stay (<4 days vs. ≥4 days, p < 0.01) and length of hospital stay (<30 days vs. ≥30 days, p < 0.01). A pre-operative stay longer than 4 days was associated with almost three times increased risk of SSI (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.05–8.34, p = 0.0407). Gastrointestinal procedures were associated with more than ten times the risk of SSI compared with other procedures (OR 10.17, 95% CI 3.82–27.10, p < 0.0001). Gastroschisis closure and necrotizing enterocolitis (NEC) laparotomies had the highest incidence SSI (54% and 62%, respectively). The risk of longer length of hospital stay after SSI was more than three times higher (OR = 3.36, 95%CI 1.63–6.94, p = 0.001). Conclusion This is the first article benchmarking the incidence of SSI in neonatal surgery in the United Kingdom. A preoperative stay ≥4 days and gastrointestinal procedures were independent risk factors for SSI. More research is needed to develop strategies to reduce SSI in selected neonatal procedures.

scholarly journals Manual Thrombus Aspiration and its Procedural Stroke Risk in Myocardial Infarction

2021 ◽  
Author(s):  
Yohei Sotomi ◽  
Yasunori Ueda ◽  
Shungo Hikoso ◽  
Daisaku Nakatani ◽  
Shinichiro Suna ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Stroke Risk ◽  
Primary Pci ◽  
Thrombus Aspiration ◽  
Coronary Insufficiency ◽  
Increased Risk ◽  
Periprocedural Stroke

Background The previous large‐scale randomized controlled trial showed that routine thrombus aspiration (TA) during percutaneous coronary intervention (PCI) was associated with an increased risk of stroke. However, real‐world clinical evidence is still limited. Methods and Results We investigated the association between manual TA and stroke risk during primary PCI in the OACIS (Osaka Acute Coronary Insufficiency Study) database (N=12 093). The OACIS is a prospective, multicenter registry of myocardial infarction. The primary end point of the present study is stroke at 7 days. A total of 9147 patients who underwent primary PCI within 24 hours of hospitalization were finally analyzed (TA group, n=4448, versus non‐TA group, n=4699 patients). TA was independently associated with risk of stroke at 7 days (odds ratio [OR], 1.92 [95% CI, 1.19‒3.12]; P =0.008) in the simple logistic regression model, while the multilevel random effects logistic regression model with hospital treated as a random effect showed that manual TA was not associated with incremental risk of stroke at 7 days (OR, 0.91 [95% CI, 0.71‒1.16]; P =0.435). The 7‐day stroke risk of manual TA was significantly heterogeneous in different institutions ( P for interaction =0.007). Conclusions Manual TA during primary PCI for patients with acute myocardial infarction was independently associated with the overall increased risk of periprocedural stroke. However, this result was substantially skewed because of institution specific risk variation, suggesting that the periprocedural stroke may be preventable by prudent PCI procedure or appropriate periprocedural management. Registration URL: https://upload.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000005464 . Unique identifier: UMIN000004575.

scholarly journals Prevalence of, and risk factors for, cognitive impairment in lacunar stroke

2022 ◽  
pp. 174749302110649
Author(s):  
Laura Ohlmeier ◽  
Stefania Nannoni ◽  
Claudia Pallucca ◽  
Robin B Brown ◽  
Laurence Loubiere ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Full Time ◽  
Lacunar Stroke ◽  
Stroke Patients ◽  
Increased Risk

Background: Small vessel disease (SVD) is associated with vascular cognitive impairment (VCI) but why VCI occurs in some, but not other patients, is uncertain. We determined the prevalence of, and risk factors for, VCI in a large cohort of patients with lacunar stroke. Methods: Participants with magnetic resonance imaging (MRI)-confirmed lacunar stroke were recruited in the multicenter DNA Lacunar 2 study and compared with healthy controls. A logistic regression model was used to determine which vascular risk factors and MRI parameters were independent predictors of VCI, assessed using the Brief Memory and Executive Test (BMET). Results: A total of 912 lacunar stroke patients and 425 controls were included, with mean ( SD) age of 64.6 (12.26) and 64.7 (12.29) years, respectively. VCI was detected in 38.8% lacunar patients and 13.4% controls. In a logistic regression model, diabetes mellitus (odds ratio (OR) = 1.98 (95% confidence interval (CI) = 1.40–2.80), p < 0.001) and higher body mass index (BMI) (OR = 1.03 (95% CI = 1.00–1.05), p = 0.029) were independently associated with increased risk of VCI, and years of full-time education with lower risk (OR = 0.92 (95% CI = 0.86–0.99), p = 0.018). When entering both lacune count and white matter hyperintensity (WMH) in the same logistic regression model, only WMH grade was significantly associated with VCI (OR = 1.46 (95% CI = 1.24–1.72), p < 0.001). Conclusion: VCI is common in lacunar stroke patients, affecting almost 40%. This prevalence suggests that it should be routinely screened for in clinical practice. Risk factors for VCI in patients with lacunar stroke include diabetes mellitus, depressive symptoms, higher BMI, and WMH severity, while education is protective.

scholarly journals Hip Stability May Influence the Development of Greater Trochanteric Pain Syndrome: A Case-Control Study of Consecutive Patients

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712095869
Author(s):  
LCDR Ashton H. Goldman ◽  
ENS Vaughn Land ◽  
Matthew H. Adsit ◽  
CDR George C. Balazs
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Binary Logistic Regression ◽  
Pain Syndrome ◽  
Posterior Wall ◽  
Binary Logistic Regression Model ◽  
Greater Trochanteric Pain Syndrome ◽  
Increased Risk ◽  
Posterior Wall Sign

Background: Greater trochanteric pain syndrome (GTPS) is thought to relate primarily to tendinosis/tendinopathy of the hip abductors. Previous studies have suggested that certain anatomic factors may predispose one to development of the condition. Hypothesis: It was hypothesized that intrinsic acetabular bony stability of the hip is related to the development of GTPS. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 198 consecutive patients diagnosed with GTPS were compared with 198 consecutive patients without clinical evidence of GTPS. Electronic health records of the included patients were examined; data recorded included patient age, sex, race, and body mass index (BMI). Standing anteroposterior radiographs were evaluated by 2 blinded examiners who measured the Tönnis angle, lateral center-edge angle (LCEA), and acetabular depth/width ratio (ADW) and assessed for the presence of a posterior wall sign. The number of dysplastic measures was recorded for each patient based on published norms. Associations between radiographic and patient variables versus the presence or absence of GTPS were determined. Factors with univariate associations where P < .20 were included in a binary logistic regression model to identify independent predictors of the presence of GTPS. Results: There was no difference between groups in terms of age, BMI, or race. There were significantly more women than men in the GTPS group (71% vs 30%; P < .001). Intraclass correlation coefficients were good for the LCEA (0.82) and Tönnis angle (0.82) and poor (0.08) for the ADW. Kappa was moderate for the presence of a posterior wall sign (0.51). An increased Tönnis angle, decreased ADW, and ADW <0.25 were significantly associated with the presence of GTPS. The binary logistic regression model identified an increased Tönnis angle ( P < .010) and female sex ( P < .001) as independent risk factors for GTPS. Conclusion: Based on this preliminary retrospective study, decreased intrinsic acetabular bony stability of the hip may be associated with an increased risk of GTPS.

scholarly journals Etiology, Incidence, and Risk Factors for Meningitis after Ventriculoperitoneal Shunt Procedures: A Multicenter Study

2020 ◽  
Vol 41 (S1) ◽  
pp. s221-s222
Author(s):  
Danilo Silva ◽  
Henrique Couto ◽  
Hoberdan Pereira ◽  
Gregory Lauar Souza ◽  
Andressa Silveira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Hospital Admission ◽  
Regression Model ◽  
Hospital Stay ◽  
Ventriculoperitoneal Shunt ◽  
Logistic Regression Model ◽  
Hospital Death ◽  
Communicating Hydrocephalus ◽  
Increased Risk

Background: The ventriculoperitoneal shunt is the main procedure used for to treat communicating hydrocephalus. Surgical site infection associated with the shunt device is the most common complication and a cause of morbidity and mortality of related to the treatment. We sought to answer 3 questions: (1) What is the risk of meningitis after ventricular shunt operations? (2) What are the risk factors for meningitis? (3) What are the main microorganisms causing meningitis? Methods: We conducted a retrospective cohort study of patients undergoing ventricular shunt operations between July 2015 and June 2018 from 12 hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the CDC NHSN. Our sample size was 926, and we evaluated 26 preoperative and operative variables by univariate and multivariate analysis. Our outcome variables of interest were meningitis and hospital death. Results: In total, 71 cases of meningitis were diagnosed (risk, 7.7%; 95% CI, 6.1%–9.6%). The mortality rate among patients without infection was 10%, whereas hospital mortality of infected patients was 13% (P = .544). The 3 main risk factors for meningitis after ventricular shunt were identified by logistic regression model: age <2 years (OR, 3.20; P < .001), preoperative hospital stay >4 days (OR, 2.02; P = .007) and >1 surgical procedure, in addition to ventricular shunt (OR, 3.23; P = .043). Almost 1 of 3 of all patients was <2 years old (290, 31%). Also, 430 patients had >4 preoperative days (46%). Patients aged ≥2 years who underwent surgery 4 days after hospital admission had an increased risk of meningitis, from 4% to 6% (P = .140). If a patient <2 years old underwent surgery 4 or more days after hospital admission, the risk of meningitis increased from 9% to 18% (P = .026; Fig. 1). We built a risk index using the number of main risk factors based on a logistic regression model (0, 1, 2 or 3; Fig. 2). Conclusions:We identified 2 intrinsic risk factors for meningitis after ventricular shunt, age <2 years and multiple surgical procedures, and 1 extrinsic risk factor, the preoperative length of hospital stay.Funding: NoneDisclosures: None

scholarly journals Consumption of Nutrition Supplements Is Associated with Less Hypoglycemia during Admission—Results from the MENU Project

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1832 ◽  
Author(s):  
Eyal Leibovitz ◽  
Fariba Moore ◽  
Irina Mintser ◽  
Anat Levi ◽  
Ron Dubinsky ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Medical Records ◽  
Logistic Regression Model ◽  
Medical Center ◽  
Nutrition Support ◽  
Oral Nutrition ◽  
Nutrition Supplement ◽  
Increased Risk

Aim: We studied the effect of the addition of an oral nutrition supplement (ONS) on the rate of hypoglyemia among hospitalized type 2 diabetes mellitus (DM) patients. Methods: In this retrospective analysis, all DM patients with hypoalbuminemia (albumin < 3.5 g/dL) admitted to internal medicine “E” at Wolfson Medical Center between 1 June 2016 and 30 April 2017 were included. One bottle of ONS (Glucerna, 330 KCAL, 28 g carbohydrates, 17 g protein, 17 g fat) was added to the morning meal. The consumption of the ONS was verified during the morning rounds. All glucose measurements were recorded automatically in the patients’ electronic medical records. A logistic regression model was used to evaluate the effect of the nutrition support on the occurrence of hypoglycemia. Results: 218 patients (mean age 77.4 ± 12.0 years, 63.3% female, mean albumin 3.13 ± 0.32 g/dL), of whom 27.9% had documented hypoglycemia during hospitalization were included. The patients consumed 69.5% ± 37.1 of the ONS provided, and ONS was started 4.3 ± 5.3 days from admission. A logistic regression model indicated that age (Odds ratio [OR] 1.048, 95% CI 1.014–1.083, p = 0.005), insulin treatment (OR 3.059, 95% CI 1.497–6.251, p = 0.002), and the day of ONS started from admission (OR 1.094, 95% CI 1.021–1.173, p = 0.011) were associated with an increased risk of hypoglycemia. Complete consumption of the ONS was associated with a reduced risk of hypoglycemia: OR 0.364, 95% CI 0.149–0.890, p = 0.027. Age, other DM medications and serum albumin did not affect the risk. Conclusion: The intake of a complete serving of ONS may be associated with a reduction of the risk of hypoglycemia among diabetes in-patients with hypoalbuminemia.

Nomogram-Derived Prediction of Postoperative Ileus after Colectomy: An Assessment from Nationwide Procedure-Targeted Cohort

2017 ◽  
Vol 83 (6) ◽  
pp. 564-572 ◽  
Author(s):  
Ahmet Rencuzogullari ◽  
Cigdem Benlice ◽  
Meagan Costedio ◽  
Feza H. Remzi ◽  
Emre Gorgun
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Postoperative Ileus ◽  
Logistic Regression Model ◽  
Operative Time ◽  
Operating Time ◽  
Stepwise Logistic Regression ◽  
Oral Antibiotic ◽  
Open Approach ◽  
Improvement Program

Postoperative ileus (POI) is a clinical burden to health-care system. This study aims to evaluate the incidence and predictors of POI in patients undergoing colectomy and create a nomogram by using recently released procedure-targeted nationwide database. Patients who underwent elective colectomy in 2012 and 2013 were identified from American College of Surgeons National Surgical Quality Improvement Program using the new procedure-targeted database. Demographics, comorbidities, and 30-day postoperative outcomes were evaluated. Variables in the final step-wise multiple logistic regression model for each outcome were selected in a stepwise fashion using Akaike's information criterion. A nomogram was created to aid in the calculation of POI risk for individual patients. A total of 29,201 patients met the inclusion criteria; 3834 (13.1%) developed POI with a male predominance (55.9%). Patients who developed ileus had longer length of hospital stay (11 vs 5 days; P < 0.001) and operative time (200 vs 174 minutes; P < 0.001). In the stepwise logistic regression model, the following variables were found to be independent risk factors for POI: older age (P < 0.001), male gender (P < 0.001), American Society of Anesthesiologists class III/IV (P < 0.001), open approach (P < 0.001), preoperative septic conditions (P < 0.001), omission of oral antibiotic before surgery (P < 0.001), right colectomy or total colectomy vs other procedures (P < 0.001), smoking (P = 0.001), decreased preoperative serum albumin level (P < 0.001), and prolonged operating time (P < 0.001). All postoperative complications were more frequently occurred in patients with POI. The nomogram accurately predicted POI with a concordant index for this model of 0.69. The use of minimal invasive techniques, control of preoperative septic conditions, oral antibiotic bowel preparation and shorter operative time are associated with a decreased rate of POI. External validation is essential for the confirmation and further evaluation of our logistic regression model and nomogram.

scholarly journals Clinical Correlates of Early-Onset Hypertension

2021 ◽  
Author(s):  
Karri Suvila ◽  
Joao A C Lima ◽  
Susan Cheng ◽  
Teemu J Niiranen
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Total Cholesterol ◽  
Early Onset ◽  
Logistic Regression Model ◽  
Multinomial Logistic Regression ◽  
Hdl Cholesterol ◽  
Multinomial Logistic Regression Model ◽  
Clinical Correlates ◽  
Increased Risk

Abstract Background Early-onset hypertension has been established as a heritable trait and a risk factor for cardiovascular disease outcomes. However, the clinical correlates of early-onset hypertension remain unidentified. Methods In this study we assessed the demographic characteristics and lifestyle factors related to hypertension onset age in a sample of 3286 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (mean baseline age 25±4 years, 57% women). We examined the association between the participants’ baseline characteristics and age of hypertension onset subgroups (&lt;35 years, 35‒44 years or ≥45 years) using a multinomial logistic regression model with those who did not develop hypertension as the reference group. Hypertension onset was defined as blood pressure ≥140/90 mmHg or antihypertensive medication use on two consecutively attended follow-up visits. Results In the multinomial logistic regression model, individuals who were black (OR, 5.08; 95% CI, 3.17–8.14), were more obese (OR, 1.57; 95% CI, 1.32–1.88), or had higher total cholesterol (OR, 1.34; 95% CI, 1.13–1.60 per SD) had increased odds of early-onset hypertension (onset at &lt;35 years) versus not developing hypertension. In contrast, 1-SD higher HDL-cholesterol was related to decreased odds of early-onset hypertension (OR, 0.71; 0.57–0.89). The odds for having earlier hypertension onset increased linearly across age of onset categories in black individuals and individuals with lower HDL-cholesterol (p&lt;0.05 for trend for both). Conclusions Our findings suggest that individuals who are black, obese, have higher total cholesterol, or have lower HDL-cholesterol level, are potentially at an increased risk of having early-onset hypertension.

scholarly journals Histological chorioamnionitis is associated with an increased risk of wheezing in preterm children less than 34 gestational weeks

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoli Wang ◽  
Haiyuan Li ◽  
Qianqian Zhang ◽  
Qianwen Shen ◽  
Dan Zhu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Multivariate Logistic Regression Model ◽  
Atopic Diseases ◽  
Multivariate Logistic Regression ◽  
Preterm Children ◽  
Increased Risk ◽  
Anthropometric Indexes

Abstract Background Chorioamnionitis is associated with various neonatal short- and long-term morbidities. The effect of chorioamnionitis on premature children’s outcomes remains controversial. The aim of this study is to investigate the relationship between histological chorioamnionitis (HCA) and physiological development, wheezing, and atopic diseases in preterm children. Methods Singleton, preterm children (< 34 weeks), whose mother underwent pathological placental examinations, were retrospectively enrolled and the outcomes were assessed at 24–40 months during follow-up. Wheezing and atopic diseases including eczema, food allergies, and allergic rhinitis were screened by a questionnaire along with medical diagnosis. Anthropometric indexes and blood pressure were measured. Cognitive and behavioural developments were assessed by the Gesell Development and Diagnosis Scale. Blood IgE and routine examination were analyzed with venous blood and serum metabolomic profiling was assessed via liquid chromatography-mass spectrometry (LC-MS). A multivariate logistic regression model was used to estimate the association between HCA and the current outcomes. Results Among the 115 enrolled children, 47 were exposed to HCA. The incidence of wheezing was significantly higher in children exposed to HCA, as 38.30% of children who were exposed to HCA and 16.18% of children who were not had been diagnosed with wheezing. After adjusting for related confounders in the multivariate logistic regression model, there remained a 2.72-fold increased risk of wheezing in children with HCA (adjusted odds ratio, aOR, 2.72; 95% confidence interval, 1.02–7.23). Moreover, 163 differential metabolites, such as butanoic acid, annotemoyin 1 and charine, were identified in the HCA exposed children’s serum. Enrichment analysis revealed that these compounds participated in diverse key metabolomic pathways relating to physical and neuro- developments, including glycerophospholipid, alpha-linolenic acid and choline metabolisms. There were no significant differences in atopic diseases, serum IgE, eosinophils’ level, anthropometric indexes, blood pressure, or cognitive or behavioural developments between the two groups. Conclusion HCA exposure is associated with an increased risk of wheezing in preterm children less than 34 gestational weeks.

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