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Published on: November 4, 2010
[Risk factors for hospital admissions among asthmatic children and adolescents]
Laura Lasmar1, Eugênio Goulart, Emília Sakurai
1Ambulatório de Pneumologia Pediátrica Campos Sales, Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
Insights
Hospital admissions for pediatric asthma are high, with many children not receiving adequate care or anti-inflammatory medication. Key risk factors include early symptom onset and recurrent emergency visits, highlighting the need for better healthcare organization.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Epidemiology
Context:
- Asthma is a prevalent chronic respiratory disease in children.
- Hospital admissions for pediatric asthma represent a significant burden on healthcare systems.
- Inadequate management and lack of preventive care contribute to severe asthma exacerbations.
Purpose:
- To determine the prevalence of hospital admissions among children with asthma.
- To identify risk factors associated with asthma-related hospitalizations in pediatric patients.
- To evaluate the quality of care provided to asthmatic children, including medication adherence and parental education.
Summary:
- A study of 325 asthmatic children revealed a high hospitalization rate (62.2%), with many experiencing onset in their first year of life.
- Severe asthma was common (76.0%), yet most children lacked anti-inflammatory treatment and parental knowledge of asthma care.
- Significant risk factors for admission included early symptom onset (before 2 years), maternal education level, disease severity, frequent emergency visits, and recurrent pneumonia.
Impact:
- Findings underscore the critical need for improved healthcare service organization to reduce pediatric asthma hospitalizations.
- Targeted interventions for children under two years old and enhanced primary care follow-up are essential.
- Better management strategies, including consistent anti-inflammatory therapy and parental education, can significantly improve outcomes for asthmatic children.
Objective:
To assess the prevalence rate and risk factors for hospital admissions among asthma children and to evaluate care delivered to these patients.
Methods:
Three-hundred and twenty-five asthmatic children attending a public outpatient reference clinic were studied. Of them, 202 were hospitalized. Care was evaluated using a questionnaire covering general aspects of hospital stay and biological, demographics, socioeconomic and asthma-related factors. Univariate and multivariate analyses were performed to measure the association between hospital admissions and selected independent variables.
Results:
Of the total, 62.2% had already been hospitalized due to asthma, 64.9% developed asthma episodes, and 60.9% were hospitalized in their first year of life. Most (76.0%) had moderate to severe asthma. Despite that, 94.2% were not on anti-inflammatory drugs and were treated only during isolated acute episodes. None of these were regularly seen in primary health care centers for a periodic control of their steroid inhalants. Most parents (97.8%) referred not to know how to take care of asthma children. Symptoms onset is normally seen before the age of 12 months (OR=3.20; 95%CI 1.55-6,61) or between 12 and 24 months (OR=3.89; 95%CI 1.62-9.36). Mothers have attended school for less than 7 years (OR=3.06; 95%CI 1.62-5.76). Disease severity (OR=2.32; 95%CI 1.24-3.88), 2 or more monthly visits to emergency wards (OR=2.19; 95%CI 1.24-3.88), and referred recurrent pneumonia (OR=2.00; 95%IC 1.06-3.80) were the main risk factors for hospital admissions.
Conclusions:
Organizing health care services is crucial to reduce hospital admissions and provide adequate care for asthma children and adolescents, especially those less than 2 years old.
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Asthma-I: Introduction
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Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include: