Hospitalizations for asthma in an urban population: 1995-1999
Hospitalizations for asthma in an urban population: 1995-1999
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DOI：
10.1016/s1081-1206(10)60165-2
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发表时间：
2009-08-01
影响因子：
5.9
通讯作者：
Sherman, Michael S.
中科院分区：
文献类型：
--
作者：
Lang, David M.;Polansky, Marcia;Sherman, Michael S.
背景：哮喘住院治疗很常见。如果哮喘得到很好的控制，许多是可以预防的。药物和人口统计学因素影响哮喘住院率。最近的研究表明，吸入长效β-受体激动剂（LABA）可能会增加严重哮喘急性发作的风险，特别是在African American.Objectives：为了进一步了解与非洲裔美国人种族相关的更大的哮喘发病率，并调查与LABA相关的可能风险。在生态分析中，在第一阶段，确定费城邮政编码区5 - 64岁人群的哮喘住院率（1995-1997年）和第二阶段（1997-1999年），并研究了与哮喘药物处方率、人口统计学因素以及哮喘护理提供者的数量和类型的关系。非裔美国人的住院率高于白人（每10，000人中有45.7对7.6），5至17岁对18至34岁和35至64岁（每10，000人中有30.4对11.9和13.7）。住院与周期1（r（s）= 0.61）和周期2（r（s）= 0.60）中吸入短效β受体激动剂（SABA）处方直接相关，与周期1（r（s）= -0.56）和周期2（r（s）= -0.66）中LABA处方呈负相关。较高的SABA处方率也与第1阶段（r（s）= 0.58）和第2阶段（r（s）= 0.53）每个邮政编码的非洲裔美国人比例较高相关。在所有贫困水平下，非裔美国人的住院率都高于白人。哮喘住院治疗与贫困地区居民（相对危险度[RR]，2.29）和非裔美国人种族（RR，4.31）和年龄（RR，1.15）作为个体水平变量（P <0.001，Poisson回归）显著相关（结论：这些数据不支持LABA暴露是哮喘发病率的主要原因的论点。哮喘住院风险与非裔美国人密切相关。《过敏性哮喘免疫学年鉴》2009;103：128-133。
Background: Asthma hospitalizations occur commonly. Many are preventable if asthma is well controlled. Medications and demographic factors affect asthma hospitalization rates. Recent studies suggest that inhaled long-acting beta-agonists (LABAs) may heighten risk of serious asthma exacerbation, particularly in African Americans.Objectives: To further our understanding of the greater asthma morbidity associated with African American race and to investigate possible risk associated with LABAs.Methods: In an ecologic analysis, asthma hospitalization rates in individuals aged 5 to 64 years were determined for Philadelphia zip codes in period 1 (1995-1997) and period 2 (1997-1999) and were studied for associations with asthma drug prescription rates, demographic factors, and numbers and types of asthma care providers.Results: Higher hospitalization rates were found in African Americans vs Caucasians (45.7 vs 7.6 per 10,000) and in 5- to 17-year-olds vs 18- to 34- and 35- to 64-year-olds (30.4 vs 11.9 and 13.7 per 10,000). Hospitalizations were correlated directly with prescriptions for inhaled short-acting beta-agonists (SABAs) in periods 1 (r(s) = 0.61) and 2 (r(s) = 0.60) and inversely with LABA prescriptions in periods 1 (r(s) = -0.56) and 2 (r(s) = -0.66). Higher SABA prescription rates were also correlated with greater proportions of African Americans per zip code in periods 1 (r(s) = 0.58) and 2 (r(s) = 0.53). At all poverty levels, African Americans had higher hospitalization rates than Caucasians. Asthma hospitalization was significantly associated with poverty area residence (relative risk [RR], 2.29) and with African American race (RR, 4.31) and age (RR, 1.15) as individual-level variables (P < .001, Poisson regression).Conclusions: These data do not support the contention that LABA exposure is a major cause of asthma morbidity. Risk of asthma hospitalization is strongly associated with being African American. Ann Allergy Asthma Immunol. 2009;103:128-133.