Incidence, risk factors and re-exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study

There are sparse real-world data on severe asthma exacerbations (SAE) in children. This multinational cohort study assessed the incidence of and risk factors for SAE and the incidence of asthma-related rehospitalization in children with asthma. Asthma patients 5-17 years old with ≥1 year of follow-u...

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Detalles Bibliográficos
Autores: Engelkes, Marjolein, Baan, Esme J.|||0000-0002-0735-4296, de Ridder, Maria A. J., Svensson, Elisabeth, Prieto-Alhambra, Daniel|||0000-0002-3950-6346, Lapi, Francesco, Giaquinto, Carlo, Picelli, Gino, Boudiaf, Nada, Albers, Frank|||0000-0001-7039-4621, Evitt, Lee A., Cockle, Sarah, Bradford, Eric, Van Dyke, Melissa K.|||0000-0001-7246-2093, Suruki, Robert, Rijnbeek, Peter|||0000-0003-0621-1979, Sturkenboom, Miriam C. J. M., Janssens, Hettie M., Verhamme, Katia M. C.
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:232703
Acceso en línea:https://ddd.uab.cat/record/232703
https://dx.doi.org/urn:doi:10.1111/pai.13237
Access Level:acceso abierto
Palabra clave:Asthma: epidemiology
Asthma: risk factors
Epidemiology: prevalence
Descripción
Sumario:There are sparse real-world data on severe asthma exacerbations (SAE) in children. This multinational cohort study assessed the incidence of and risk factors for SAE and the incidence of asthma-related rehospitalization in children with asthma. Asthma patients 5-17 years old with ≥1 year of follow-up were identified in six European electronic databases from the Netherlands, Italy, the UK, Denmark and Spain in 2008-2013. Asthma was defined as ≥1 asthma-specific disease code within 3 months of prescriptions/dispensing of asthma medication. Severe asthma was defined as high-dosed inhaled corticosteroids plus a second controller. SAE was defined by systemic corticosteroids, emergency department visit and/or hospitalization all for reason of asthma. Risk factors for SAE were estimated by Poisson regression analyses. The cohort consisted of 212 060 paediatric asthma patients contributing to 678 625 patient-years (PY). SAE rates ranged between 17 and 198/1000 PY and were higher in severe asthma and highest in severe asthma patients with a history of exacerbations. Prior SAE (incidence rate ratio 3-45) and younger age increased the SAE risk in all countries, whereas obesity, atopy and GERD were a risk factor in some but not all countries. Rehospitalization rates were up to 79% within 1 year. In a real-world setting, SAE rates were highest in children with severe asthma with a history of exacerbations. Many severe asthma patients were rehospitalized within 1 year. Asthma management focusing on prevention of SAE is important to reduce the burden of asthma.

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