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Epidemiological characterization of pediatric patients with status asthmaticus admitted to intensive care units

Mariel Silva1, Luis Muñoz, Tania Diaz

  • 1Hospital Episcopal San Lucas, Ponce School of Medicine Consortium, Ponce, Puerto Rico 00716-4725.

Boletin De La Asociacion Medica De Puerto Rico
|December 4, 2009
PubMed

Insights

Pediatric asthma admissions to the Pediatric Intensive Care Unit (PICU) are high in Puerto Rican children. Suboptimal asthma management, particularly a lack of preventive medication, is linked to health insurance type.

Area of Science:

  • Pediatric Pulmonology
  • Public Health
  • Health Services Research

Background:

  • Asthma morbidity and mortality have risen, with Puerto Rican children experiencing the highest US prevalence.
  • Pediatric Intensive Care Unit (PICU) admissions for asthma signify severe disease.
  • Asthma management in hospitalized children often remains suboptimal.

Purpose of the Study:

  • To describe the profile of pediatric patients admitted to the PICU with status asthmaticus.
  • To identify factors associated with severe asthma exacerbations requiring PICU admission.
  • To investigate the relationship between health insurance and preventive asthma medication use.

Main Methods:

  • An ambispective cohort chart review was conducted.
  • The study analyzed 46 pediatric cases admitted to Hospital Episcopal San Lucas PICU over three years.
  • Data included patient demographics, medical history, asthma classification, insurance status, and medication use.

Main Results:

  • The average age of admitted children was 6.2 years, with a 70% male predominance.
  • A significant proportion (48%) had persistent asthma, yet only 19% received preventive medications.
  • Children with Puerto Rico's Health Care Reform (72% of patients) were less likely to receive preventive treatment (79% vs. 46% for private insurance).

Conclusions:

  • Background asthma management is inadequate in children requiring hospitalization.
  • Lack of preventive medication in persistent asthmatics is strongly associated with having Puerto Rico's Health Care Reform insurance.
  • Health insurance type appears to be a significant barrier to optimal asthma preventive care in this pediatric population.

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