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Risk factors leading to hospital admission in Iranian asthmatic children
Mostafa Moin1, Asghar Aghamohammadi, Mohammad Hossein Gharavi
1Immunology, Asthma and Allergy Research Institute, Department of Clinical Immunology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. mmoin@sina.tums.ac.ir
Insights
Asthma hospitalizations in children are linked to factors like recent infections, allergies, and prior hospital stays. Regular follow-up and inhaled corticosteroid use may reduce admission risks.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Epidemiology
Background:
- Asthma is a prevalent chronic respiratory disease globally, contributing to significant healthcare utilization.
- Childhood asthma exacerbations frequently necessitate emergency room visits and hospital admissions.
- Understanding pediatric asthma admission triggers is crucial for effective management and prevention strategies.
Purpose of the Study:
- To identify key factors associated with hospital admission in pediatric asthma patients.
- To compare characteristics of asthmatic children requiring hospitalization versus those managed outpatient.
- To inform clinical practice and public health initiatives for asthma control in children.
Main Methods:
- A case-control study was conducted at a referral hospital for asthma and allergy.
- Sixty-three asthmatic children requiring admission were compared with 63 controls (discharged or clinic-referred).
- Data were collected via structured questionnaires during clinical interviews.
Main Results:
- Cases (hospitalized) were younger (mean age 5 vs. 6 years) and had higher rates of personal/familial allergic history (69.8%/57.1% vs. 34.9%/36.5%).
- Asthmatic children admitted had a greater history of recent respiratory infections (79.4% vs. 49.2%) and prior asthma hospitalizations (57.1% vs. 23.8%).
- Regular use of inhaled corticosteroids was significantly lower in the case group (66.7% vs. 33.3%).
Conclusions:
- Recent respiratory infections, prior hospitalizations, personal/familial allergy history, and younger age are significant risk factors for childhood asthma admission.
- Regular clinical follow-up, consistent inhaled corticosteroid use, higher IgE levels, and adequate O2 saturation may decrease hospitalization probability.
- These findings underscore the importance of adherence to treatment guidelines and proactive management in preventing severe asthma exacerbations in children.
Background:
Asthma is one of the most common chronic diseases in the world, leading to an increased rate of hospitalization. We performed this study to better understand the factors leading to admission among asthmatic children.
Methods:
We performed a study among asthmatic children in a referral hospital for asthma and allergy in Tehran. Sixty-three cases were selected from asthmatic children admitted to the emergency room (ER) who still had an indication for ward or intensive care unit admission after primary treatment. Our control group was the asthmatic children discharged after primary treatment and patients who were referred to the asthma and allergy clinic (63 patients). Data were obtained by structured questionnaires filled out during clinical interviews.
Results:
There was a significant difference in mean age (5 years for cases vs. 6 years for controls; p = 0.049), personal and familial allergic history (69.8 and 57.1% for cases vs. 34.9 and 36.5% for controls; p < 0.01 and p = 0.02, respectively), history of recent respiratory infections (79.4% for cases vs. 49.2% for controls; p < 0.01), hospitalization history due to asthma (57.1% for cases vs. 23.8% for controls; p < 0.01) and regular use of inhaled corticosteroid (66.7% for cases vs. 33.3% for controls; p < 0.01).
Conclusions:
Our findings confirm most previous observations, suggesting that recent respiratory infections, hospitalization, personal or familial allergy, disease severity and lower ages are important factors leading to hospitalization. We also found that regular clinical follow-up, regular use of inhaled corticosteroids, higher IgE levels and O2 saturation may lower the probability of hospitalization during asthmatic attacks.
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