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Predictors for multiple hospital admissions in children with asthma
1Dicle University Hospital, Diyarbakir, Turkey. fuatgurkan@hotmail.com
Insights
Preventing indoor smoking, particularly maternal smoking, can reduce childhood asthma hospitalizations. Younger children under five years old are at higher risk for asthma admissions.
Area of Science:
- Pediatrics
- Environmental Health
- Respiratory Medicine
Background:
- Asthma is a leading cause of preventable pediatric hospitalizations.
- Identifying risk factors for recurrent asthma exacerbations is crucial for effective management.
Purpose of the Study:
- To investigate environmental and patient characteristics associated with multiple hospital admissions for acute asthma attacks in children.
- To identify preventable risk factors for future asthma-related hospitalizations.
Main Methods:
- Analysis of 140 children (3-15 years) with asthma admitted to a university hospital over three years.
- Evaluation of clinical findings, laboratory results, and detailed case histories to identify predictors of hospital admissions.
- Statistical analysis including Chi-squared tests and multivariate logistic regression.
Main Results:
- Multiple asthma admissions were observed in 21.4% of children.
- Significant risk factors for frequent hospital admissions included indoor cigarette smoking, maternal smoking, dermal atopy, allergic conjunctivitis, and age under five.
- Maternal smoking and age under five were identified as significant independent predictors of multiple hospital admissions via logistic regression.
Conclusions:
- Reducing indoor smoking, especially maternal smoking, is a key strategy to decrease asthma hospitalizations in children.
- Children younger than five years old represent a vulnerable group with a higher likelihood of hospitalization for asthma.
Background:
Asthma is one of the most frequent causes of preventable hospital admissions among children.
Objectives:
To identify preventable risk factors for future hospital admissions. Some of the environmental and patient characteristics of children who were hospitalized more than once with an acute asthma attack were investigated.
Design, Setting And Patients:
An analysis was performed of 140 children with asthma, aged three to 15 years, admitted to the Department of Pediatrics at Dicle University Hospital, Diyarbakir, Turkey, over three years, followed for a maximum of 48 months. Associations between hospital admissions and probable predictors (clinical findings, laboratory studies and a detailed case history) were analyzed.
Results:
The asthma admissions were higher in boys than in girls (male to female ratio 1.86). Of 140 children, 30 (21.4%) had multiple admissions, defined as a mean of more than one admission per year during the follow-up period. The following factors were associated significantly with the frequency of hospital admission for asthma attacks when analyzed using a Chi2 test: indoor cigarette smoking (odds ratio [OR] 2.55), maternal smoking (OR 4.05), symptoms of dermal atopy (OR 2.96), symptoms of allergic conjunctivitis (OR 2.68), age less than five years (OR 5.12) and use of inhaled corticosteroids during the follow-up (OR 0.37). With multi-variate logistic regression analysis, among other factors, only maternal smoking (r=0.29, P=0.017) and age less than five years (r=-0.32, P=0.012) were significant effective factors for the multiple hospital admissions. No significant association with the frequency of hospital admission was found for sex, serum total immunoglobulin E, history of frequent upper respiratory tract infections or number of family members.
Conclusions:
Prevention of indoor smoking, especially maternal smoking, may be effective in decreasing hospital admissions in children with asthma. Children less than five years of age are more likely to be hospitalized than are children five years of age or greater.