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Risk factors for intensive care in children with acute asthma

Patricia J Lyell1, Elmer Villanueva, Debbie Burton

  • 1Department of Respiratory and Sleep Medicine, Monash Medical Centre, Melbourne, Victoria, Australia.

Respirology (Carlton, Vic.)
|September 2, 2005
PubMed

Insights

Very severe asthma in children is linked to factors like male gender and inhaled corticosteroid use. Understanding these risk factors can help prevent near-fatal asthma (NFA) events in pediatric patients.

Area of Science:

  • Pediatric Pulmonology
  • Clinical Epidemiology

Background:

  • Severe asthma exacerbations requiring intensive care represent near-fatal asthma (NFA) events.
  • Identifying risk factors for NFA in children is crucial for effective management and prevention.

Purpose of the Study:

  • To identify risk factors associated with very severe asthma (near-fatal asthma) in pediatric patients.
  • To compare risk factors between children with NFA and those with less severe asthma requiring only emergency department visits.

Main Methods:

  • A retrospective case-control study was conducted at Monash Medical Centre.
  • Cases were children admitted to the intensive care unit (ICU) for asthma (n=52), compared to controls admitted to the emergency department (n=53).
  • Data were collected from patient files and structured telephone interviews, analyzed using univariate and multivariate logistic regression.

Main Results:

  • Univariate analysis showed NFA patients were older, had longer asthma duration, hay fever, used inhaled corticosteroids and long-acting beta(2) agonists, had management plans, and saw respiratory specialists.
  • Multivariate analysis identified male gender (OR, 5.7) and inhaled corticosteroid use (OR, 7.2) as potential predictors of NFA.
  • Parental smoking was not a significant factor.

Conclusions:

  • Several factors are associated with near-fatal asthma in children, some mirroring findings in adult asthma.
  • While asthma severity plays a role, independent risk factors like male gender and asthma duration are suggested in pediatric NFA.
  • These findings highlight potential targets for intervention and improved asthma management in children.
Abstract

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