Factors affecting readmission for asthma exacerbation in children attending Alexandria university children-hospital
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20190519Keywords:
Acute asthma attacks. Asthma triggers, Controller medication, Children, EgyptAbstract
Background: The admission rate for bronchial asthma has increased dramatically all over the world. This increase in admission influences the children’s quality of life in addition to health care cost. Objective of the study was to identify the risk factors for readmission because of acute asthmatic attacks.
Methods: Case control study applied on asthmatic children admitted because of acute asthma attacks attending emergency room, paediatric intensive care unit and inpatient wards of Alexandria university children's hospital, Alexandria, Egypt in the period from September 2016 to July 2017. The study group was subdivided into 2 groups; group (A) readmitted within one year from first admission and group (B) firstly admitted.
Results: The mean age in group (A) and (B) was 9.09±3.98 and 8.65±4.01 respectively. Males were more than females in both groups, and no sex differentiation effects on readmission. The duration of the disease in readmitted group ranged from 1-8 years, it was a risk factor for acute asthma readmission. Viral infection, exercise and dust were risk factors for acute asthma exacerbation readmission. Disease severity was found to have a higher percentage of hospitalization; cases with severe and moderate bronchial asthma compared to mild cases. Readmitted patients had more sleep disturbance and lack of school attendance. Readmitted patients were less adherent to treatment.
Conclusions: Duration of the disease, viral infections, common cold, dust and exercise are risk factors for acute asthma readmission. Severity of the disease and adherence to medications affect acute asthma readmission.
References
Global Initiative for Asthma. Global strategy for asthma management and prevention, 2015. Available at http://www.ginasthma.org/local/ uploads/files/GINA_Report. Accessed 01 January 2019.
Weinberg EG. Urbanization and childhood asthma: an African perspective. J Allergy Clin Immunol. 2000;105:224-31.
Braman SS, Skloot GS. Pulmonary Disease in the Aging Patient, an Issue of Clinics in Geriatric Medicine, E-Book. Elsevier Health Science; 2017.
Murray C, poletti G, Kebadze T, Morris J, Woodcock A, Johnston S, et al. Study of modifiable risk factors for asthma exacerbations: virus infection and allergen exposure increase the risk of asthma hospital admissions in children. Thorax. 2006;61:376-82.
Akinbami L. Centers for Disease Control and Prevention National Center for Health Statistics. Asthma prevalence, health care use and mortality: United States, 2010.
van Boven JFM, Pharm D, Ryan D, Eakin MN, Canonica GW, Barot A, et al. Enhancing Respiratory Medication Adherence: The Role of Health Care Professionals and Cost-Effectiveness Considerations. J Allergy Clin Immunol Pract. 2016;4(5):835-46.
Bannier M, Van de Kant, jobsis Q. Biomarkers to predict asthma in wheezing preschool children. Clin Exp Allergy. 2015;45:1040-50.
Celedón JC. Achieving Respiratory Health Equality: A United States Perspective. Humana Press. 2016;205.
Amany H, Gamalat M. Effect of socioeconomic factors on the onset of menarche in mansoura city girls. J Am Sci. 2012;8:545-50.
Delmas MC, Marguet C, Raherison C. Readmissions for asthma in France in 2002- 2003. Rev Mal Respir. 2011;28:0115-22.
Liu SY, Peariman DN. Hospital readmissions for childhood asthma: the role of individual and neighborhood factors. Public Health Rep. 2009;124:65-78.
Korhonen K, Dunder T, Klaukka T. Use of inhaled corticosteroids decreases hospital admissions for asthma in young children. World J Pediatr. 2009;5:177-81.
Akrishman JA, Diette GB, Skinner EA, Clark BD, Steinwachs D, Wu AW. Race and sex differences in consistency with national asthma guidelines in managed care organizations. Arch Intern Med. 2001;161:1660-8.
Gwynn RC. Risk factors for asthma in US adults: results from the 2000 behavioral risk factor surveillance system. J Asthma. 2004;41:91-8.
Okada H, Kuhn C, Feillet H, Bach J. The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update. Clin Exp Immunol J. 2010;160:1-9.
El-Margoushy N, El Nashar M, Khairy H, El Nashar N, Mohamad H. Effect of Air Pollution, Contamination and High Altitude on Bronchial Asthma. Egyptian J Hospital Med. 2013;50:169–78.
Lindbaek M, Wefring KW, Grangard EH, Kumar RN. Socioeconomical conditions as risk factors for bronchial asthma in children aged 4-3 years. Eur Respir J. 2003;21:103-8.
Bernstein JA, Levy ML. Clinical Asthma: Theory and Practice. CRC Press, 2014;337.
Duran-Tauleria E, Rona RJ. Geographical and socioeconomic variation in the prevalence of asthma symptoms in English and Scottish children. Thorax. 1999;54:476-81.
Melk H, Beydoun A, Khogali M, Tamim H, Yunis A. Household crowding index: a correlate of socioeconomic status and inter-pregnancy spacing in an urban setting. J Epidemiol Community Health. 2004;58:476-80.
James P, Judith A. Kemp D. Management of asthma in children. Am Fam Physician. 2001;63:1341-8.
De Groot EP, Nijkamp A, Duiverman EJ, Brand PL. Allergic rhinitis is associated with poor asthma control in children with asthma. Thorax. 2012;67(7):582-7.
Van Cauwenberge P, Watelet JB, van Zeie T. Does rhinitis lead to asthma? Rhinology. 2007;45:112-21.
Corren J. The connection between allergic rhinitis and bronchial asthma. Curr Opin Pulm Med. 2007;13(1):13-8.
Passalacqua G, Durham SR. Allergic rhinitis and its impact on asthma update: allergen immunotherapy. J Allergy Clin Immunol. 2007;119:881-91.
Benayoun L, Druilhe A, Dombert MR, Aubier M and Pretolani M. Airway structural alterations selectively associated with severe asthma. Am J Respir Crit Care 2003;167(10):1360-8.
Bai TR, Cooper J, Koelmeyer T, Paré PD, Weir TD. The Effect of Age and Duration of Disease on Airway Structure in Fatal Asthma. Am J Respir Crit Care Med 2000; 162: 663-9.
De Blic J, Boucot I, Pribil C, Robert J, Huas D, Marguet C. Control of asthma in children: still unacceptable? a French cross-sectional study. Respir Med. 2009;103:1383-91.
Khertsuriani N, Kazerouni NN, Erdman DD, Lu X, Redd SC, Anderson LJ, et al. Prevalence of viral respiratory tract infections in children with asthma. J Allergy Clin Immunol. 2007:119(2):3l4-21.
Busse WW, Lemanske RF Jr, Gem JE. The role of viral respiratory infections in asthma and asthma excerbationd. Lancet. 2010;376(9743):826-34.
Institute of Medicine, Committee on the Assessment of Asthma and Indoor Air. Clearing the Air: Asthma and Indoor Air Exposures. Washington, DC: National Academy Press; 2000.
Etzel RA. How Environmental Exposures Influence the Development and Exacerbation of Asthma. Pediatrics. 2003;112:1.
Alaa A, Sallam MM, Fathy GA. Epidemiological study of the prevalence of bronchial asthma and other atopic diseases among school children. Int J Acad Res. 2010;2:209-17.
Gianniou N, Roviana N. Poor asthma control in clinical practice: quantifying the perspective of improvement. Pneumon. 2008;21:283-92.
Trevor JL, Chipps BE. Severe Asthma in Primary Care: Identification and Management. Am J Med. 2018;131(5):484–491.
Jentzsch NS, Camargos P, Sarinho ES, Bousquet J. Adherence rate to beclomethasone dipropionate and the level of asthma control. Respir Med. 2012;13(3):338-43.
Laforest L, Belhassen M, Devouassoux G, Didier A, Ginoux M, Van Ganse E. Long-Term Inhaled Corticosteroid Adherence in Asthma Patients with Short-Term Adherence. J Allergy Clin Immunol Pract. 2016;5(4):890-9.
Bülow AV, Kriegbaum M, Backer V, Porsbjerg C. Poor asthma control is associated with low socio-economic status: Results from a nationwide cross sectional study of Danish patients with asthma. European Resp J. 2015;46(59):2024.
Azeez IA, Ladipo MMA, Ige OM. Assessment of Socioeconomic Status and Control of Asthma in Adults. Ann Ib Postgrad Med. 2016;14(2):85–91.