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Time trends in acute childhood asthma in Basque Country, Spain
J Benito1, J L Bayon, J Montiano
1Division of Pediatric Emergency Medicine, Basque Country University, País Vasco, Spain.
Insights
Emergency asthma visits in children decreased by 18% between 1987-1992. Despite fewer visits, hospital admissions rose, indicating more severe cases requiring intensive treatment and inhaled anti-inflammatory therapies.
Area of Science:
- Pediatrics
- Epidemiology
- Respiratory Medicine
Background:
- Asthma is a significant pediatric respiratory condition.
- Understanding trends in pediatric asthma management is crucial for public health.
- Hospital data provides insights into acute asthma epidemiology.
Purpose of the Study:
- To analyze changes in the epidemiology of childhood asthma in a hospital setting.
- To identify trends in emergency visits, hospital admissions, and treatment intensity for pediatric asthma.
- To assess shifts in management strategies for acute asthma in children.
Main Methods:
- Retrospective review of hospital data from the Basque region, Spain.
- Analysis of pediatric asthma cases between 1987 and 1992.
- Comparison of emergency visit rates, admission rates, length of stay, and treatment protocols.
Main Results:
- A significant 18% decrease in emergency visits for pediatric asthma (2-14 years).
- A paradoxical 35.9% increase in hospital admission rates for pediatric asthma.
- Increased intensity of emergency room treatment, including nebulized beta 2-agonists and oral prednisolone, and higher use of inhaled anti-inflammatory maintenance therapy.
Conclusions:
- While overall emergency visits declined, pediatric asthma cases requiring hospitalization became more severe.
- Treatment intensity in emergency rooms and the use of maintenance anti-inflammatory therapies increased.
- Shifting patterns in pediatric asthma epidemiology suggest changes in disease severity or management approaches.
Abstract:
To investigate recent changes in the epidemiology of acute asthma in children in a hospital setting, data from the Basque region of Bizkaia, Spain were reviewed for the period between 1987 and 1992. Over this period there was a 18% drop in hospital emergency visits for asthma in children aged 2-14 years from 1,697/100,000 to 1,382/100,000. It was associated with a decline in the number of annual episodes per patient and in the number of patients needing further hospital treatment for the same episode. Paradoxically, hospital admission rates rose by 35.9% from 298/100,000 to 405/100,000. A trend toward decreasing length of hospital stay, a fall in the number of intensive care unit admissions, and an absence of in-hospital deaths were observed. Comparing data from September 1987 with those of September 1992, a trend has been noticed toward greater intensity of emergency room treatment with increases in the number of doses of nebulized beta 2-agonists administered and in courses of oral prednisolone given. In September 1992 more patients were on maintenance "anti-inflammatory" inhaled therapy than in 1987.