Association of Asthma With Treatments and Outcomes in Children With Critical Influenza.
Association of Asthma With Treatments and Outcomes in Children With Critical Influenza.
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哮喘与危重流感儿童的治疗和结果之间的关系。
DOI：
10.1016/j.jaip.2022.10.045
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Sanders
中科院分区：
文献类型：
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作者：
Maddux,AlineB;Grunwell,JocelynR;Newhams,MargaretM;Chen,SabrinaR;Olson,SamanthaM;Halasa,NatashaB;Weiss,ScottL;Coates,BriaM;Schuster,JenniferE;Hall,MarkW;Nofziger,RyanA;Flori,HeidiR;Gertz,ShiraJ;Kong,Michele;Sanders
Backgroundhospitalizationfor severe influenza infection in childhood may result in postdischarge symptoms. Objective. Objective评价因流感伴或不伴哮喘的危重呼吸系统疾病患儿的住院管理和出院后后遗症。儿童观察性多中心研究（8个月至17岁）因流感入住儿科重症监护室或高敏病房（2019年11月至2020年4月）。结果按既存哮喘分层。收集院前状态、住院治疗和结局。出院后约90天的调查评估出院后的卫生资源的使用，功能状态，和呼吸道symptoms.ResultsA共165名儿童流感：56与预先存在的哮喘（33.9%）和109没有它（66.1%，分别为41.1%和39.4%，完全接种流感疫苗）。15例既存哮喘患者（26.7%）和34例无哮喘患者（31.1%）进行了插管。住院期间接受哮喘药物治疗的既存哮喘患者多于无既存哮喘患者（76.7% vs 28.4%）。在136例有90天调查数据的患者中（82.4%; 46例既存哮喘[33.8%]，90例无哮喘[66.1%]），因呼吸系统疾病而急诊/急诊就诊（4.3% vs 6.6%）或再次入院（8.6% vs 3.3%）的比例相似。既存哮喘患者更常出现哮喘症状（78.2% vs 3.3%），出院后更常接受呼吸科专家访视（52% vs 20%）。在109例无既往哮喘的患者中，有10例报告接受了新的哮喘诊断（11.1%）。ConclusionsRespiratory health resource use and symptoms are important postdischarge outcomes after influenza critical illness in children with and without preexisting asthma。不到一半的儿童接种了流感疫苗，这是一种可以减轻重症及其后遗症的工具。
BackgroundHospitalization for severe influenza infection in childhood may result in postdischarge sequelae.ObjectiveTo evaluate inpatient management and postdischarge sequelae in children with critical respiratory illness owing to influenza with or without preexisting asthma.MethodsThis was a prospective, observational multicenter study of children (aged 8 months to 17 years) admitted to a pediatric intensive care or high-acuity unit (in November 2019 to April 2020) for influenza. Results were stratified by preexisting asthma. Prehospital status, hospital treatments, and outcomes were collected. Surveys at approximately 90 days after discharge evaluated postdischarge health resource use, functional status, and respiratory symptoms.ResultsA total of 165 children had influenza: 56 with preexisting asthma (33.9%) and 109 without it (66.1%; 41.1% and 39.4%, respectively, were fully vaccinated against influenza). Fifteen patients with preexisting asthma (26.7%) and 34 without it (31.1%) were intubated. More patients with versus without preexisting asthma received pharmacologic asthma treatments during hospitalization (76.7% vs 28.4%). Of 136 patients with 90-day survey data (82.4%; 46 with preexisting asthma [33.8%] and 90 without it [66.1%]), a similar proportion had an emergency department/urgent care visit (4.3% vs 6.6%) or hospital readmission (8.6% vs 3.3%) for a respiratory condition. Patients with preexisting asthma more frequently experienced asthma symptoms (78.2% vs 3.3%) and had respiratory specialist visits (52% vs 20%) after discharge. Of 109 patients without preexisting asthma, 10 reported receiving a new diagnosis of asthma (11.1%).ConclusionsRespiratory health resource use and symptoms are important postdischarge outcomes after influenza critical illness in children with and without preexisting asthma. Less than half of children were vaccinated for influenza, a tool that could mitigate critical illness and its sequelae.