Risk factors for recurrent respiratory tract infections or acute
respiratory failure in children with spinal muscular atrophy
Introduction: Assessment of and intervention for
sleep-disordered breathing and malnutrition are related to respiratory
management for preventing recurrent respiratory tract infections (RRTIs)
and acute respiratory failure (ARF) in children with spinal muscular
atrophy (SMA). However, the specific standard has not been clarified.
Purpose: The study aimed to obtain the risk factors and the
predictive index for RRTIs and/or ARF in children with SMA.
Methods: In this retrospective study, the differences in
clinical characteristics in patients with or without RRTIs and ARF were
compared, and binary logistic regression analysis was carried out. The
best cutoff points of the positive predictive index were obtained.
Results: Type 1 (OR = 4.12, 95% CI 1.30-13.07, P =.016) and
apnea hypopnea index (AHI) (OR = 1.14, 95% CI 1.05-1.24, P =.001) were
risk factors, while body mass index z score (BMIz) (OR = 0.68, 95% CI
0.49-0.94, P =.018) and mean pulse oxygen saturation (MSpO
2) (OR = 0.67, 95% CI 0.50-0.91, P =.010) were
protective factors. The sensitivity and specificity of the standard of
MSpO 2 < 96% and AHI > 10
events/h or BMIz < -1 with the occurrence of RRTIs and/or ARF
were 0.513 and 0.957, respectively. Conclusion: SMA Type 1,
BMIz, AHI and MSpO 2 should be used to estimate the risk
for RRTI or ARF in children with SMA. MSpO 2 <
96%, and AHI > 10 events/h or BMIz < -1 should
be used as the intervention standard.