Impact of Obesity on Asthma Morbidity During a Hospitalization.
Impact of Obesity on Asthma Morbidity During a Hospitalization.
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DOI：
10.1542/hpeds.2017-0265
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发表时间：
2018-09-01
影响因子：
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通讯作者：
Rastogi, Deepa
中科院分区：
文献类型：
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作者：
Gross, Elissa;Lee, Diana S;Rastogi, Deepa
背景：哮喘和肥胖是两个常见的儿科问题。肥胖是已知的哮喘危险因素，患有哮喘的肥胖儿童有更高的疾病负担。然而，很少有人知道如何肥胖的城市少数民族儿童，主要是西班牙裔和非洲裔美国儿童，影响发病率在儿科哮喘hospitalizations.METHODS：一个回顾性的图表审查进行了2至18岁的儿童和青少年在Montefiore儿童医院住院的急性哮喘加重。我们阐明了超重或肥胖状态与急性加重的严重程度的关系，通过住院时间（LOS）和重症监护管理的需要来量化。进行多因素分析，以确定独立的预测LOS.RESULTS：共975名儿童符合纳入标准，其中55%是正常体重和45%是超重或肥胖。60%是西班牙裔，37%是非洲裔美国人。总体平均LOS为2.57天（范围：0.67-12.92）。超重或肥胖状态与基线时哮喘严重程度较高相关（P = 0.021）。超重或肥胖儿童与正常体重儿童相比，平均住院时间更长（2.75 vs 2.39天; P <0.01），PICU住院时间更长（P = 0.006），即使调整了基线哮喘严重程度。恶化的严重程度并没有不同的种族。结论：肥胖的哮喘住院儿童与更严重的哮喘急性发作，更长的LOS，并增加使用PICU水平的护理，独立于他们较高的基线疾病的严重程度和种族。
BACKGROUND: Asthma and obesity are 2 common pediatric problems. Obesity is a known risk factor for asthma, and obese children with asthma have higher disease burden. However, little is known on how obesity in urban minority children, mainly Hispanic and African American children, impacts morbidity during pediatric asthma hospitalizations.METHODS: A retrospective chart review was conducted on children and adolescents age 2 to 18 years hospitalized at the Children's Hospital at Montefiore for an acute asthma exacerbation. We elucidated the association of overweight or obese status with severity of the exacerbation, quantified by length of stay (LOS) and need for intensive care management. Multivariate analysis was conducted to identify independent predictors of LOS.RESULTS: A total of 975 children met the inclusion criteria, of whom 55% were normal weight and 45% were overweight or obese. Sixty percent were Hispanic, and 37% were African American. The overall average LOS was 2.57 days (range: 0.67-12.92). Overweight or obese status was associated with a higher asthma severity at baseline (P = .021). Overweight or obese children had a longer average LOS compared with normal weight children (2.75 vs 2.39 days; P < .01) with more PICU stays (P = .006), even after adjustment for higher baseline asthma severity. The severity of the exacerbation did not differ by ethnicity.CONCLUSIONS: Obesity in children hospitalized for asthma is associated with more severe asthma exacerbations, longer LOS, and increased use of PICU level care, independent of their higher baseline disease severity and ethnicity.