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Hospitalization, asthma phenotypes, and readmission rates in pre-school asthma

  • Objective: Children with pre-school asthma suffer disproportionally more often from severe asthma exacerbations with emergency visits and hospital admissions compared to school children. Despite this high disease burden, there are only a few reports looking at this particular severe asthma cohort. Similarly, there is little real-life research on the distribution of asthma phenotypes and personalized treatment at discharge in this age group. Patients and Methods: Retrospective analysis of the electronic charts of all children aged 1–5 years with asthma hospitalizations (ICD J45) at the Frankfurt University between 2008 and 2017. An acute severe asthma exacerbation was defined as dyspnea, oxygen demand, and/or systemic steroid therapy. Age, gender, duration of hospitalization, asthma phenotype, treatment, and readmission rate were analyzed. Results: Of 572 patients, 205 met the definition of acute severe asthma. The phenotypic characterization showed 56.1% had allergic asthma, 15.2% eosinophilic asthma and 28.7% non-allergic asthma. Of these patients, 71.7% were discharged with inhaled corticosteroids (ICS) or ICS + long-acting-beta-agonists (LABA), 15.1% with leukotriene antagonists (LTRA) and 7.3% salbutamol on demand. The rate of emergency presentations (emergency department and readmission) within 12 months after discharge was high (n = 42; 20.5%). No phenotype tailored treatment was detectable. Neither the number of eosinophils (>300/μl) nor the treatment at discharge had an effect on emergency visits and readmission rate. Conclusion: Despite protective therapy with ICS, ICS + LABA, or LTRA, the readmission rate was high. Thus, current care and treatment strategies should be reevaluated continuously, in order to better control asthma in pre-school children and prevent hospitalization.

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Metadaten
Author:Helena DonathORCiDGND, Sven KlugeGND, Georgia Sideri, Jordis TrischlerGND, Silvija-Pera JerkicORCiD, Johannes B. SchulzeORCiDGND, Stefan ZielenORCiDGND, Katharina BlümchenORCiDGND
URN:urn:nbn:de:hebis:30:3-562233
DOI:https://doi.org/10.3389/fped.2020.562843
ISSN:2296-2360
Parent Title (English):Frontiers in Pediatric
Publisher:Frontiers Media
Place of publication:Lausanne
Document Type:Article
Language:English
Date of Publication (online):2020/01/20
Date of first Publication:2020/11/20
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/12/07
Tag:asthma phenotypes; hospitalization; pre-school asthma; readmission rates; tailored treatment schedule
Volume:8
Issue:art. 562843
Page Number:9
First Page:1
Last Page:9
Note:
This study was in part funded by Boehringer Ingelheim with 25,000€.
HeBIS-PPN:478133685
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0