Risk factors for asthma admissions in children
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Published on: August 7, 2017
Angela P Gaspar1, Mário A Morais-Almeida, Graça C Pires
1Department of Immunoallergy, Dona Estefânia Hospital, Rua Jacinta Marto, 1169-045 Lisboa, Portugal.
Insights
Childhood asthma hospitalization is linked to prior admissions, tobacco smoke, and allergen sensitization. Early diagnosis and preventive measures are crucial for high-risk children.
Area of Science:
- Pediatrics
- Allergology
- Public Health
Background:
- Childhood asthma presents a significant public health challenge with high morbidity.
- Asthma exacerbations frequently lead to emergency room visits and hospital admissions in children.
Purpose of the Study:
- To identify key risk factors associated with childhood asthma hospitalization.
- To compare risk factors in hospitalized children with a matched outpatient cohort.
Main Methods:
- A cohort of 124 children hospitalized for asthma was studied over two years.
- Data collected via standardized questionnaires and skin-prick tests (SPTs).
- Comparison with a matched group of pediatric asthma outpatients.
Main Results:
- Significant risk factors for hospitalization included prior asthma admissions, environmental tobacco smoke exposure, allergen sensitization, maternal asthma history, and early symptom onset (before 12 months).
- Protective factors identified were attendance at daycare/kindergarten and larger family size.
- Prior asthma hospitalization (OR=7.63) and environmental tobacco smoke (OR=6.63) were strong predictors.
Conclusions:
- Early diagnosis and specialized care are vital for high-risk pediatric asthma patients.
- Preventive strategies, including environmental tobacco smoke avoidance and aeroallergen limitation, are essential.
- Risk stratification aids in targeted asthma management and reducing hospitalizations.
Abstract:
Bronchial asthma is related to a high morbidity rate, leading to an increasing frequency of emergency room visits and hospital admissions. The aim of this study was to identify severity risk factors for childhood asthma related to hospitalization. The authors studied 124 children admitted to the hospital for asthma, during a 2-year period, correlating the obtained data with a sample of outpatients with asthma matched by age, gender, and socioeconomic status. A standardized questionnaire and skin-prick tests (SPTs) were performed on all children. The significant and independent risk factors identified for hospital admission were prior asthma hospitalization (OR = 7.63; 95% CI = 1.5-39.6; p = 0.01) and last-year admission (OR = 3.18; 95% CI = 1.1-8.9; p = 0.02), environmental tobacco-smoke exposure (OR = 6.63; 95% CI = 2.5-17.8; p = 0.002), allergen sensitization (OR = 3.86; 95% CI = 1.4-10.7; p = 0.009), family history of maternal asthma (OR = 3.58; 95% CI = 1.3-9.6; p = 0.01), and onset of symptoms before 12 months of age (OR = 2.76; 95% CI = 1.0-7.9; p = 0.06). Attendance at day care or kindergarten (OR = 0.38; 95% CI = 0.2-0.9; p = 0.04) and large family size (OR = 0.25; 95% CI = 0.1-0.8; p = 0.01) could be protective factors. Our results stress the importance of early diagnosis and specialized medical care of childhood asthma, mainly in high-risk children, with emphasis on medication planning and the establishment of preventive measures such as environmental tobacco smoke avoidance and limitation of aeroallergen exposure.
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