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Follow-up study on factors influencing the persistence of asthma in discharged children
Huimin Zou1, Peng Han1,2, Ju Yin1
1Respiratory Department, Beijing Children's Hospital, China National Clinical Research Center of Respiratory Diseases, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Insights
Asthma persistence in children is linked to allergic rhinitis and frequent early exacerbations. Regular follow-up and consistent inhaled corticosteroid use may improve asthma management outcomes.
Area of Science:
- Pediatric Pulmonology
- Clinical Epidemiology
- Asthma Research
Background:
- Asthma in children is characterized by periods of persistence, relapse, and remission.
- Understanding factors influencing these patterns is crucial for effective management.
- This study investigates asthma management and associated factors in children at Beijing Children's Hospital.
Purpose of the Study:
- To investigate the landscape of asthma management in children.
- To identify personal factors associated with asthma persistence and remission.
- To analyze outcomes in children aged 0-18 years post-hospitalization for acute asthma attacks.
Main Methods:
- Retrospective cohort study of children hospitalized for acute asthma attacks (2019-2021).
- Data collected via questionnaire on asthma management and post-discharge attacks.
- Logistic regression used to identify factors linked to remission and persistence.
Main Results:
- 152 children completed follow-up (median 2.76 years).
- Only 31.6% had regular follow-up visits; 36.8% used inhaled corticosteroids (ICS) regularly.
- Asthma persistence was associated with allergic rhinitis (OR=3.88), ≥3 early exacerbations (OR=12.34), and unplanned early healthcare visits (OR=8.61).
Conclusions:
- A significant proportion of children (50.7%) experienced persistent asthma symptoms.
- Allergic rhinitis and frequent early asthma exacerbations/healthcare visits are key predictors of persistence.
- Improved adherence to regular follow-up and anti-asthma treatment is needed.
Background:
The process of asthma, after its onset, is featured by periods of persistence, relapse and remission. This follow-up study is aim to investigate the landscape of asthma management and personal factors associated with persistence and remission in children aged 0-18 years at Beijing Children's Hospital.
Methods:
This was a retrospective cohort study. Children hospitalized in Beijing Children's Hospital from 2019 to 2021 due to acute asthma attacks were included as study participants. A questionnaire was used to collect information on both asthma management and the occurrence of any asthma attacks following discharge. We defined asthma remission as the absence of asthma symptoms for one year, in contrast to persistent asthma. Logistic regression analyses were performed to identify factors associated with asthma remission and persistence.
Results:
A total of 210 children with asthma were enrolled in this study. Of these, 152 (72.4%) completed the follow-up and were included in the final analysis. The median follow-up time was 2.76 years (interquartile range (IQR), 2.18-3.95). Among these patients, the frequency of asthma attacks after discharge varied with different follow-up duration. 31.6% of children with asthma had regular follow-up visits, 36.8% had regular use of inhaled corticosteroids (ICS) for 3 months or more, and 42.8% used ICS only for asthma symptoms. There were 75 children with remission of asthma and 77 children with persistence. Multivariate logistic regression analysis identified three factors associated with asthma persistence: allergic rhinitis (odds ratio (OR) = 3.88, 95% confidence interval (CI): 1.54-9.75), ≥ 3 exacerbations in Early Period (OR = 12.34, 95% CI: 4.74-32.14) and unplanned healthcare attendances in Early Period (OR = 8.61, 95% CI: 2.51-29.51).
Conclusions:
After discharge, some children had acute asthma attacks. About 30% were engaged in regular follow-up and anti-asthma treatment. 50.7% of the children with asthma have experienced persistent asthma symptoms in the past year. Allergic rhinitis, ≥ 3 acute asthma attacks in Early Period, and unplanned healthcare attendances in Early Period were associated with asthma persistence.
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