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Decline in admissions for childhood asthma, a 26-year period population-based study
Ingvild Bruun Mikalsen1, Liliane Skeiseid1, Line Merete Tveit1
1Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.
Insights
Hospital admissions for childhood asthma in Norway increased until 1990 but significantly declined by 2010. This trend suggests improved asthma management or fewer severe asthma exacerbations in children.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Public Health
Background:
- Childhood asthma prevalence has risen globally.
- Hospitalization rates for pediatric asthma showed an increasing trend in Norway from 1984 to 2000.
Purpose of the Study:
- To investigate the trends in hospital admissions for childhood asthma up to 2010 in Norway.
- To identify demographic and clinical factors associated with asthma hospitalizations.
Main Methods:
- Population-based study analyzing medical records of children aged 1-13 hospitalized for asthma between 1984/1985 and 2009/2010.
- Data collected included gender, age, admission frequency, hospital stay duration, medications, and symptoms.
Main Results:
- Asthma admission rates peaked in 1989/1990 and subsequently declined significantly by 2009/2010.
- Boys and younger children exhibited higher admission rates. Readmissions were more frequent than primary admissions.
- There was a marked increase in the use of inhaled corticosteroids and systemic steroids during the study period.
Conclusions:
- A substantial decrease in childhood asthma hospitalizations occurred after 1989/1990.
- The decline may be attributed to enhanced asthma care or a genuine reduction in severe asthma exacerbations.
- Significant variations in trends were observed across different age groups and genders.
Background:
The prevalence of childhood asthma has increased, although the rate of hospitalization for asthma seems to decrease. In Norway, the rate of hospital admission for childhood asthma from 1984 to 2000 increased. The aim of this study was to assess further trends in hospital admissions for childhood asthma up to 2010.
Methods:
A population-based study including children 1-13 yrs of age hospitalized for asthma during six periods from 1984/1985 to 2009/2010 in Rogaland, Norway, was performed. Medical records from 1536 admissions (1050 children) were studied; and gender, age, number of admissions, length of hospital stay, medications and symptoms were recorded.
Results:
For all age groups, the rate of admissions per 10.000 increased from 20.1 in 1984/85 to 33.7 in 1989/90, but declined to 14.4 in 2009/2010. Rates were highest in boys (OR 1.87; 95% CI: 1.69, 2.09), younger age groups (OR 2.51; 2.38, 2.64) and decreased from 1984 to 2010 (OR 0.92; 0.88, 0.94). The rates of readmissions were higher than for primary admissions (OR 1.33; 1.19, 1.47). From 1984 to 2010, there was an increased use of inhaled corticosteroids prior to admission (6 to 51%) and started at discharge (7 to 37%), and systemic steroids given during admission (19 to 83%).
Conclusion:
There has been a substantial decline in the rate of hospital admissions for childhood asthma after 1989/1990, with major differences between age groups and genders. The decline could be due to improved care of children with asthma or a real reduction in asthma exacerbations.
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