Impact of Obesity on Asthma Morbidity During a Hospitalization
Elissa Gross1,2, Diana S Lee3,2, Arda Hotz4
1Children's Hospital at Montefiore, Bronx, New York; egross@montefiore.org.
Insights
Pediatric asthma hospitalizations are more severe in obese children. Obesity is linked to longer hospital stays and increased intensive care needs, regardless of ethnicity.
Area of Science:
- Pediatric Pulmonology
- Childhood Obesity Research
- Epidemiology of Asthma
Background:
- Asthma and obesity are prevalent pediatric conditions.
- Obesity is a known risk factor for asthma, increasing disease burden.
- Limited data exists on obesity's impact on pediatric asthma hospitalizations in urban minority populations.
Purpose of the Study:
- To investigate the association between overweight/obesity and asthma severity in hospitalized children.
- To determine if obesity impacts length of stay and intensive care unit (ICU) admission rates.
- To identify predictors of length of stay in pediatric asthma exacerbations.
Main Methods:
- Retrospective chart review of 975 children (ages 2-18) hospitalized for asthma exacerbation.
- Analysis of overweight/obese status against asthma severity markers: length of stay (LOS) and pediatric intensive care unit (PICU) admission.
- Multivariate analysis to identify independent predictors of LOS.
Main Results:
- 45% of hospitalized children were overweight or obese.
- Overweight/obese children experienced more severe asthma at baseline (P=.021).
- Obesity was associated with longer average LOS (2.75 vs 2.39 days, P<.01) and higher PICU admission rates (P=.006), independent of baseline severity.
Conclusions:
- Childhood obesity is independently associated with increased asthma severity during hospitalizations.
- Obese children hospitalized for asthma require longer stays and more intensive care.
- Ethnicity did not influence asthma exacerbation severity in this cohort.
Background:
Asthma and obesity are 2 common pediatric problems. Obesity is a known risk factor for asthma, and obese children with asthma have higher disease burden. However, little is known on how obesity in urban minority children, mainly Hispanic and African American children, impacts morbidity during pediatric asthma hospitalizations.
Methods:
A retrospective chart review was conducted on children and adolescents age 2 to 18 years hospitalized at the Children's Hospital at Montefiore for an acute asthma exacerbation. We elucidated the association of overweight or obese status with severity of the exacerbation, quantified by length of stay (LOS) and need for intensive care management. Multivariate analysis was conducted to identify independent predictors of LOS.
Results:
A total of 975 children met the inclusion criteria, of whom 55% were normal weight and 45% were overweight or obese. Sixty percent were Hispanic, and 37% were African American. The overall average LOS was 2.57 days (range: 0.67-12.92). Overweight or obese status was associated with a higher asthma severity at baseline (P = .021). Overweight or obese children had a longer average LOS compared with normal weight children (2.75 vs 2.39 days; P < .01) with more PICU stays (P = .006), even after adjustment for higher baseline asthma severity. The severity of the exacerbation did not differ by ethnicity.
Conclusions:
Obesity in children hospitalized for asthma is associated with more severe asthma exacerbations, longer LOS, and increased use of PICU level care, independent of their higher baseline disease severity and ethnicity.
Related Concept Videos
00:59Hospitals-II
Nurses that work in...
01:28Hospitals-I
01:24Obesity
01:29Asthma-I: Introduction
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes: