Seasonality of Asthma: A Retrospective Population Study
Seasonality of Asthma: A Retrospective Population Study
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DOI：
10.1542/peds.2013-2022
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发表时间：
2014-04-01
期刊：
影响因子：
8
通讯作者：
Balicer, Ran D.
中科院分区：
文献类型：
--
作者：
Cohen, Herman Avner;Blau, Hannah;Balicer, Ran D.
目的：哮喘的季节性变化已得到广泛认可，九月发病率最高。这项回顾性人口研究旨在调查这一结论在初级保健中的一大群哮喘儿童中是否成立，并评估年龄、性别、城市/农村生活和人口部门的影响。 方法：关键研究结果是家庭医生在 2005 年至 2009 年期间记录的哮喘加重诊断和哮喘药物处方。这些结果按 Clalit Health Services 电子病历数据库中的“诊断周”进行分析。建立回归模型来评估长期趋势、季节性和年龄组在解释哮喘急性发作发生率方面的相对强度。结果：总共确定了 919873 名 2 至 15 岁儿童。其中，82234 人（8.9%）患有哮喘，其中男孩占 61.6%，女孩占 38.4%； 49.1% 年龄为 2 至 5 岁，24.1% 为 6 至 9 岁，26.8% 为 10 至 15 岁。我们观察到，与 8 月份相比，9 月份（第 37-39 周与第 34-36 周）小儿哮喘急性发作增加了 2.01 倍，哮喘支气管扩张药物处方增加了 2.28 倍。在 2 至 5 岁（比值比，2.15）和 6 至 11 岁（1.90 倍）儿童中，开学与哮喘相关就诊发生率之间的关联性最大。青少年（12-15 岁）的峰值较小（1.81 倍）。秋末出现第二次上升，整个冬季持续波动，夏季达到低谷。结论：夏季后重返学校与哮喘发作和不定期就诊初级保健医生的风险增加密切相关。
OBJECTIVES: Seasonal variations in asthma are widely recognized, with the highest incidence during September. This retrospective population study aimed to investigate whether this holds true in a large group of asthmatic children in primary care and to assess the impact of age, gender, urban/rural living, and population sector.METHODS: The key study outcomes were the diagnosis of asthma exacerbations and asthma medication prescriptions, recorded by family physicians during 2005 to 2009. These were analyzed by ''week of diagnosis'' in Clalit Health Services' electronic medical record database. Regression models were built to assess relative strength of secular trends, seasonality, and age-group in explaining the incidence of asthma exacerbations.RESULTS: A total of 919873 children aged 2 to 15 years were identified. Of these, 82234 (8.9%) were asthmatic, 61.6% boys and 38.4% girls; 49.1% aged 2 to 5 years, 24.1% 6 to 9 years, and 26.8% 10 to 15 years. We observed a 2.01-fold increase in pediatric asthma exacerbations and 2.28-fold increase in prescriptions of asthma bronchodilator medications during September (weeks 37-39 vs weeks 34-36) compared with August. The association between the opening of school and the incidence of asthma-related visits to the primary care physician was greatest in children aged 2 to 5 years (odds ratio, 2.15) and 6 to 11 years (1.90-fold). Adolescents (age 12-15 years) had a lesser peak (1.81-fold). In late fall there was a second rise, lasting with fluctuations throughout winter, with a trough in summer.CONCLUSIONS: Returning to school after summer is strongly associated with an increased risk for asthma exacerbations and unscheduled visits to the primary care physician.