CAUSES OF DELAYED DIAGNOSIS OF BRONCHIAL ASTHMA IN CHILDREN AND ITS CLINICAL CONSEQUENCES
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Objective: To identify the primary causes of delayed diagnosis of bronchial asthma in children and to assess the impact of this delay on the clinical course and outcomes of the disease. Methods: A retrospective cohort study was conducted by analyzing 450 medical records of children (aged 6-16) with a confirmed diagnosis of asthma, who were followed at a specialized pediatric center. Patients were divided into two groups: Group 1 (Early Diagnosis, n=210), diagnosed within 12 months of symptom onset, and Group 2 (Late Diagnosis, n=240), diagnosed more than 24 months after symptom onset. Data on initial misdiagnoses and clinical outcomes (frequency of exacerbations, number of hospitalizations, need for oral corticosteroids (OCS), and pulmonary function (FEV1%)) were collected and compared. Results: The average diagnostic delay in Group 2 was 3.8 ± 1.5 years. The most common misdiagnosis preceding the correct asthma diagnosis was "recurrent obstructive bronchitis" (71% of cases in Group 2). Children in the Late Diagnosis group had significantly worse clinical outcomes: a higher annual rate of severe exacerbations (2.1 ± 0.8 vs. 0.5 ± 0.4 in Group 1; p<0.001), more frequent hospitalizations (1.5 ± 0.6 vs. 0.2 ± 0.1 per year; p<0.001), a greater need for OCS courses (3.2 ± 1.1 vs. 0.8 ± 0.5 per year; p<0.001), and lower FEV1% predicted values at the time of diagnosis (75% ± 8% vs. 89% ± 6%; p<0.001). Conclusion: Delayed diagnosis of bronchial asthma in children leads to a more severe clinical course, characterized by frequent exacerbations, increased hospitalizations, and poorer lung function. The primary reason for the delay is the misinterpretation of asthma symptoms as recurrent respiratory infections. Improving the knowledge of primary care physicians on modern asthma guidelines and raising parental awareness are crucial steps to ensure timely diagnosis and prevent adverse long-term outcomes.
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