Status of Childhood Asthma in the United States, 1980-2007
Status of Childhood Asthma in the United States, 1980-2007
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DOI：
10.1542/peds.2008-2233c
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发表时间：
2009-03-01
期刊：
影响因子：
8
通讯作者：
Sondik, Edward J.
中科院分区：
文献类型：
--
作者：
Akinbami, Lara J.;Moorman, Jeanne E.;Sondik, Edward J.
疾病控制和预防中心的数据用于描述1980-2007年0至17岁儿童的趋势，以及根据性别、种族和年龄的最新模式。从1980年到1996年，哮喘期患病率每年增加4.6%。1997年采取的新措施显示，目前处于历史高位；2007年，9.1%的美国儿童（670万）目前患有哮喘。20世纪90年代，门诊就诊率波动较大，而急诊科就诊率和住院率略有下降。与哮喘相关的死亡率在20世纪90年代中期上升，但在1999年之后下降。最近的数据显示，年龄较大的儿童（11-17岁）患病率较高，但与哮喘相关的医疗保健使用率最高的是年龄最小的儿童（0-4岁）。在控制患病率的种族差异后，不良后果的差异仍然存在；在患有哮喘的儿童中，非西班牙裔黑人儿童与非西班牙裔白人儿童相比，急诊科就诊和死亡的风险更高。对于没有西班牙裔数据的住院，黑人儿童比白人儿童有更大的风险。然而，非西班牙裔黑人儿童的非紧急门诊护理使用率较低。虽然儿童哮喘患病率的大幅增加已经减少，但负担仍然很大。本可避免的不良后果和种族差异继续构成挑战。这些发现表明需要对儿童进行持续的哮喘预防和控制。儿科2009;123: S131-S145
Centers for Disease Control and Prevention data were used to describe 1980-2007 trends among children 0 to 17 years of age and recent patterns according to gender, race, and age. Asthma period prevalence increased by 4.6% per year from 1980 to 1996. New measures introduced in 1997 show a plateau at historically high levels; 9.1% of US children (6.7 million) currently had asthma in 2007. Ambulatory care visit rates fluctuated during the 1990s, whereas emergency department visits and hospitalization rates decreased slightly. Asthma-related death rates increased through the middle 1990s but decreased after 1999. Recent data showed higher prevalence among older children (11-17 years), but the highest rates of asthma-related health care use were among the youngest children (0-4 years). After controlling for racial differences in prevalence, disparities in adverse outcomes remained; among children with asthma, non-Hispanic black children had greater risks for emergency department visits and death, compared with non-Hispanic white children. For hospitalizations, for which Hispanic ethnicity data were not available, black children had greater risk than white children. However, nonemergency ambulatory care use was lower for non-Hispanic black children. Although the large increases in childhood asthma prevalence have abated, the burden remains large. Potentially avoidable adverse outcomes and racial disparities continue to present challenges. These findings suggest the need for sustained asthma prevention and control efforts for children. Pediatrics 2009; 123:S131-S145