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Published on: February 2, 2017
Association of obesity with severity outcomes in hospitalized pediatric asthma exacerbations
Raymond Parlar-Chun1,2, Grace Truong2, Tasia Isbell2
1Children's Memorial Hermann, Houston, TX, USA.
Insights
Obesity in children with asthma does not appear to increase hospital stay, ICU admission, or magnesium use. However, obese children with asthma showed increased odds of requiring continuous albuterol for exacerbations.
Area of Science:
- Pediatric Pulmonology
- Obesity Medicine
- Clinical Epidemiology
Background:
- The relationship between obesity and asthma severity in children is not well understood.
- Investigating if obesity correlates with more severe asthma exacerbations requiring hospitalization is crucial.
Purpose of the Study:
- To examine the association between obesity and asthma exacerbation severity in hospitalized children.
- To assess outcomes including hospital length of stay, intensive care unit (ICU) admission, and need for continuous albuterol or magnesium.
Main Methods:
- Retrospective review of 995 pediatric patients (ages 4-17) hospitalized for asthma between 2012-2016.
- Obesity defined as body mass index (BMI) ≥95th percentile.
- Analysis using multivariate logistic regression and negative binomial regression.
Main Results:
- No significant differences in length of stay, ICU admission, or magnesium administration between obese and non-obese children.
- Obese children with asthma had higher odds of requiring continuous albuterol (OR 1.47 [1.02, 2.11]).
Conclusions:
- Obesity is not associated with increased hospital length of stay, ICU admission, or magnesium use in pediatric asthma exacerbations.
- While obesity is linked to asthma, it may not significantly worsen overall exacerbation severity outcomes in this cohort, except for continuous albuterol need.
Introduction:
While there seems to be an association between obesity and asthma, the exact nature of the relationship remains unknown. It is unclear if there is increased severity of exacerbation for those that require hospitalization. We examine the association between obesity and severity outcomes such as hospital length of stay, intensive care admissions, and need for continuous albuterol or magnesium administration.
Methods:
Patients 4 to 17 years old admitted between 1/1/2012-1/1/2016 with asthma identified by discharge codes were reviewed. Obesity was defined as BMI ≥95%. Clinical data such as age, gender, family history of asthma, use of controller medication along with outcome data such as length of stay, ICU admission, use of continuous albuterol, and use of magnesium were collected. Binary outcomes were analyzed with multivariate logistic regression while length of stay was analyzed with negative binomial regression.
Results:
Overall, 995 patients met inclusion criteria. The median age was 7 years old with 170 (17%) patients categorized as obese. We find no difference in length of stay (IRR 0.99 [0.91, 1.09], p = 0.9), PICU admission (OR 0.72 [0.43, 1.21], p = 0.22), or magnesium administration (OR 1.34 [0.95, 1.88], p = 0.09) between obese and non-obese patients. There were increased odds of continuous albuterol use (OR 1.47 [1.02, 2.11]) for obese patients.
Conclusion:
We find no association between obesity and outcomes of length of stay, ICU admission, or magnesium administration. While growing evidence links obesity with asthma, our study suggests it may not be associated with the severity of exacerbation.
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