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Asthma severity among children hospitalized in 1990 and 1995
J R Meurer1, V George, S Subichin
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee 53226, USA. jmeurer@mcw.edu
Insights
The proportion of high-severity asthma hospitalizations in children remained stable between 1990 and 1995. However, factors like patient age, sex, geographic region, and hospital type influenced severity.
Area of Science:
- Pediatric Pulmonology
- Health Services Research
- Epidemiology
Background:
- Childhood asthma prevalence increased over a decade.
- Pediatric asthma hospitalizations showed a declining trend.
- Understanding factors influencing asthma severity in hospitalized children is crucial.
Purpose of the Study:
- To determine the proportion of high-severity asthma cases among children hospitalized with asthma.
- To investigate associations between high-severity asthma and patient/hospital characteristics.
Main Methods:
- Utilized the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) database.
- Analyzed data from 1990 and 1995, including over 29,000 and 33,000 pediatric asthma patients, respectively.
- Classified asthma severity using All Patient Refined-Diagnosis-Related Groups (APR-DRGs) and employed logistic regression analysis.
Main Results:
- High-severity asthma was frequently linked to respiratory distress and failure.
- The proportion of high-severity cases remained consistent (4.2% in 1990 vs. 4.6% in 1995).
- Adolescents, boys, and patients treated at urban teaching hospitals in western, southern, and north-central regions showed higher severity.
Conclusions:
- The proportion of high-severity pediatric asthma hospitalizations did not significantly change between 1990 and 1995.
- Patient demographics (age, sex) and hospital characteristics (region, teaching status) were associated with variations in high-severity asthma cases.
Background:
During the past decade, the number of children with asthma increased; however, the number of asthma hospitalizations for children decreased.
Objective:
To assess the proportion of high-severity cases among children hospitalized with asthma and the association of high-severity asthma with patient and hospital characteristics.
Design:
The data set used was the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Records were selected of patients 18 years and younger who had the principal diagnosis of asthma. Records were analyzed of 29077 patients at 746 hospitals in 1990 and 33 443 patients at 811 hospitals in 1995. Asthma severity was classified by All Patient Refined-Diagnosis-Related Groups. Cross-sectional logistic regression analysis was performed using survey data analysis software.
Results:
The most common diagnoses associated with high-severity asthma were respiratory distress and respiratory failure. The proportion of high-severity asthma cases did not change significantly between 1990 (4.2%) and 1995 (4.6%) (P = .08). Adolescents and boys were more likely to have high-severity asthma than children aged 5 to 12 years and girls. Western, southern, and north-central hospitals and urban teaching hospitals had a higher proportion of high-severity asthma cases than northeastern hospitals and nonteaching hospitals.
Conclusions:
Between 1990 and 1995, the proportion of high-severity cases among children hospitalized with asthma did not change significantly. However, patient age, sex, region of the country, and hospital teaching status were associated with variations in the proportion of high-severity asthma cases.