Adverse asthma outcomes among children hospitalized with asthma in California
Adverse asthma outcomes among children hospitalized with asthma in California
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DOI：
10.1542/peds.101.5.845
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发表时间：
1998-05-01
期刊：
影响因子：
8
通讯作者：
Carlisle, DM
中科院分区：
文献类型：
--
作者：
Calmes, D;Leake, BD;Carlisle, DM
Objective.使用管理数据来确定儿童哮喘住院治疗的不良哮喘结局是否与特定的临床和非临床患者特征相关。横断面研究。设置。1986年至1993年加利福尼亚州所有与哮喘相关的儿科（0至17岁）出院患者。共有113974例符合条件的哮喘相关出院患者。主要结果测量。不良哮喘结局（插管、心肺骤停和死亡）。0.48%的受试者发生了不良哮喘结局。与1986年相比，20世纪90年代期间不良哮喘结局的频率增加。在控制了性别、年龄、特定共病条件、年份、种族和保险类型的差异后，不良哮喘结局更可能发生在5至11岁组（比值比[OR]：1.39; 95%置信区间[CI]：1.13-1.69）和12- 17岁组（OR：4.48; CI：3.20-6.21）。与白色儿童相比，亚太裔美国儿童更容易发生不良哮喘结局（OR：1.59; CI：1.24-2.59）。有肺炎的次要诊断的儿童（OR：1.54; CI：1.19-2.00）也更有可能经历不良哮喘结局。1986年后，不良结局的几率逐渐增加，1989年后变得显著。性别和保险类型与发生哮喘不良结局的几率增加无关。在20世纪90年代，住院儿童中的不良哮喘结果正在增加，并且与特定的临床和非临床患者特征相关。
Objective. To use administrative data to determine whether adverse asthma outcomes for pediatric asthma hospitalizations are related to specific clinical and nonclinical patient characteristics.Design. Cross-sectional study.Setting. All pediatric (0 to 17 years of age) asthma-related hospital discharges, 1986 to 1993, in California.Patients. A total of 113 974 eligible patients with asthma-related discharges.Main Outcome Measure. Adverse asthma outcomes (intubation, cardiopulmonary arrest, and death).Results. Adverse asthma outcomes occurred in 0.48% of subjects. The frequency of adverse asthma outcomes increased during the 1990s compared with 1986. After controlling for differences in gender, age, specific comorbid conditions, year, race, and insurance type, adverse asthma outcomes were more likely to occur in the 5- to 11-year-old group (odds ratio [OR]: 1.39; 95% confidence interval [CI]: 1.13-1.69) and in the 12- to 17-year-old group (OR: 4.48; CI: 3.20-6.21) compared with those children in the 0 to 4-year-old age group. Asian Pacific-American children were more likely (OR: 1.59; CI: 1.24-2.59) than were white children to experience an adverse asthma outcome. Children who had a secondary diagnoses of pneumonia (OR: 1.54; CI: 1.19-2.00) also were more likely to experience an adverse asthma outcome. The odds of an adverse outcome increased progressively after 1986, becoming significant after 1989. Gender and insurance type were not associated with increased odds of experiencing an adverse asthma outcome.Conclusions. Adverse asthma outcomes among hospitalized children are increasing in the 1990s and are associated with specific clinical and nonclinical patient characteristics.