Trends in hospital admissions due to asthma in north-west Spain from 1995 to 2007

doi:10.1016/j.aller.2009.11.008

Allergologia et Immunopathologia

Volume 38, Issue 5, September–October 2010, Pages 254-258

https://doi.org/10.1016/j.aller.2009.11.008 Get rights and content

Abstract

Purpose

Asthma is the most common chronic disease in childhood. Hospital admissions in the child population appear to be reducing in different populations.

Methods

We have retrospectively analysed admissions into hospitals in our region due to asthma in a 0 to 14 years population, between the years 1995 and 2007. The age, sex, date of admission, and length of hospital stay of each patient was recorded and analysed.

Results

A total of 9106 admissions (64% males) have been included. A gradual trend towards a reduction in admissions is observed during the period analysed. There were more admissions in 1996, with 2.91 per thousand inhabitants, gradually reducing to 1.33 per thousand in 2007. There were more admissions in May and between September and December, being less frequent in July and August. The mean stay in this period was 4.18 days, which was stable during the whole period of the study. Older children tended to have a longer hospital stay.

Conclusions

Our study shows that admissions due to childhood asthma tend to be decreasing, particularly due to younger males, with no change in the length of hospital stay. Asthma exacerbations seemed to be associated with infections and exposure to allergens.

Introduction

Asthma is the most common chronic disease in childhood, with large differences in prevalence as well as in other epidemiological aspects among different populations.¹

In the last few years the prevalence of the disease appears to be stabilising in the adolescent population, although it is still increasing in the child population.²

Hospital admissions take up a significant part of the health spending on the disease, in addition to the effects on the quality of life of the patients and their families, which is especially important in the childhood population.³ There seems to have been a decreasing trend in hospital admissions due to childhood asthma in the past few years, although its magnitude and time sequence differ between geographical areas.4, 5, 6, 7

The aim of our study was to evaluate the progression of hospital admissions due to asthma over the past 13 years in the north-west of Spain.

Section snippets

Material and methods

We have retrospectively analysed all admissions due to asthma in all the Galician (Spain) Public Health Service Hospitals, between the years 1995 and 2007. All patients with asthma as the primary or secondary diagnosis (provided by the Clinic Records Department, according to ICD-9 classification) were included. The age, sex, date of admission and length of hospital stay of each patient was recorded and analysed.

There were 315,825 children (51.4% males) between 0 and 14 years of age in our

Results

There were 9106 hospital admissions with asthma as the primary or secondary diagnosis in the 13 years analysed; with a predominance of males (64% of the total admissions), and 47% were under 4 years (Table 1; Figure 1).

A decreasing trend in the number of hospital admissions due to asthma was observed during the period studied, particularly in younger males (Figure 1). The highest number of admissions was seen in 1996, with 2.91 per thousand inhabitants, gradually falling to 1.33 per thousand in

Discussion

The principal finding in our study was the gradual reduction, over the period studied, in the number of hospital admissions due to asthma, especially in boys under 4 years; similar to that described in other populations.4, 5, 6, 7

The rate of hospital admissions per inhabitant is lower than that reported for other child populations of these ages.4, 5

The decrease in hospital admissions, despite the increase in prevalence of the disease in this population group,² is probably due to the influence

References (30)

S.S. Braman
The global burden of asthma
Chest
(2006)
A. Sykes et al.
Etiology of asthma exacerbations
J Allergy Clin Immunol
(2008)
R. Jimenez Garcia et al.
de Miguel AG. Influenza vaccination coverages among children, adults, health care workers and immigrants in Spain: related factors and trends, 2003–2006
J Infect
(2008)
L. Héguy et al.
Associations between grass and weed pollen and emergency department visits for asthma among children in Montreal
Environ Res
(2008)
E.R. Cabanas Rodriguez et al.
Predictors of the persistence of childhood asthma
Allergol Immunopathol (Madr)
(2008)
P.J. Gergen et al.
Understanding the seasonal pattern of childhood asthma: results from the National Cooperative Inner-City Asthma Study (NCICAS)
J Pediatr.
(2002)
M.R. Sears et al.
Understanding the September asthma epidemic
J Allergy Clin Immunol.
(2007)
F.J. González Barcala et al.
Parental smoking and lung function in healthy children and adolescents
Arch Bronconeumol
(2007)
A. López-Silvarrey Varela et al.
Prevalence of asthma and rhinitis symptoms in A Coruña (Spain)
An Pediatr (Barc)
(2007)
N. Pearce et al.
Comparison of asthma prevalence in the ISAAC and the ECRHS. ISAAC Steering Committee and the European Community Respiratory Health Survey. International Study of Asthma and Allergies in Childhood
Eur Respir J
(2000)

L. García-Marcos et al.

Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain

Allergy

(2004)

O. Säynäjäkangas et al.

Trends in hospitalization for childhood asthma in Finland in 1996–2004

Acta Paediatr.

(2007)

K. Priftis et al.

Hospitalizations for childhood asthma in Athens, Greece, from 1978 to 2000

Pediatr Allergy Immunol

(2005)

K.N. Priftis et al.

Decrease in childhood asthma admissions in Athens, Greece from 2001 to 2005

Acta Paediatr

(2007)

H.R. Anderson et al.

50 years of asthma: UK trends from 1955 to 2004

Thorax

(2007)

Cited by (11)

Global Asthma Network survey suggests more national asthma strategies could reduce burden of asthma
2017, Allergologia et Immunopathologia
Citation Excerpt :
They developed and called it a comprehensive nationwide Asthma Programme and over the next decade this lessened the burden of asthma on individuals and society and more than halved the total asthma costs (healthcare, drugs, disability, and productivity loss)6,7 and these benefits have continued.8 This model was followed several years later by several other national strategies within the European Union9 including France,10 Portugal,11 and Spain.12 In other places, independent approaches have been used with improved outcomes, including Australia,13 the city of Salvador, Brazil,14 Canada,15 Costa Rica,16 Singapore,17 Tonga18 and Turkey.19
Several countries or regions within countries have an effective national asthma strategy resulting in a reduction of the large burden of asthma to individuals and society. There has been no systematic appraisal of the extent of national asthma strategies in the world.
The Global Asthma Network (GAN) undertook an email survey of 276 Principal Investigators of GAN centres in 120 countries, in 2013–2014. One of the questions was: “Has a national asthma strategy been developed in your country for the next five years? For children? For adults?”.
Investigators in 112 (93.3%) countries answered this question. Of these, 26 (23.2%) reported having a national asthma strategy for children and 24 (21.4%) for adults; 22 (19.6%) countries had a strategy for both children and adults; 28 (25%) had a strategy for at least one age group. In countries with a high prevalence of current wheeze, strategies were significantly more common than in low prevalence countries (11/13 (85%) and 7/31 (22.6%) respectively, p < 0.001).
In 25% countries a national asthma strategy was reported. A large reduction in the global burden of asthma could be potentially achieved if more countries had an effective asthma strategy.
A nationwide survey of the severity, comorbidity, and mortality of hospitalized patients with asthma in taiwan
2013, Pediatrics and Neonatology
Citation Excerpt :
Comorbidities of disease may cause asthma to be more severe resulting in increased death, especially among older patients. In many studies, it has been demonstrated that the mortality rate increased with advanced age despite the presence of comorbidities.7–20 In the current study, no mortality event was defined as “death from asthma” in any patient aged below 60 years; another study reported the existence of death resulting from asthma in patients aged 60 years or less (rate of mortality for 45–64 years old was 1.5 per 100,000 during 2002–2003).17
To clarify the epidemiology of asthma admission in a nationwide survey, we analyze the characteristics of hospitalized patients in Taiwan.
Data regarding asthma-associated hospitalizations were obtained from the National Health Insurance Research Database of Taiwan from January 2001 to December 2002. Patient characteristics in terms of severity, mortality, and cost were stratified by age, gender, and presence of comorbidities.
A total of 59,983 hospitalizations with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 493.xx and asthma-related treatment were included in the current analysis. When stratified by age, the number and duration of hospitalizations were distributed in J-shape distribution, with the nadir located in the range of 8–18 years of age. The severity of asthma was found to increase with age (p < 0.001) and was more severe in men compared with women (p < 0.001). The severity of in-hospital patients was significantly greater in subjects with underlying respiratory disease compared to patients with other comorbidities, such as cardiovascular disease and infectious disease. The mortality rates of all hospitalized asthma patients and pediatric hospitalized asthma patients were 0.77% and 0.02%, respectively. The risk factor for mortality of asthma was older age and male gender in multiple regression.
The severity of asthma increased after 18 years of age. Increased comorbidities in elderly patients might contribute to asthma severity. The mortality rate was low in pediatric patients and significantly increased in males and the elderly. The above findings suggest that additional effort is required in the treatment of elderly and male asthmatic patients.
The role of an allergy and clinical Immunology department in supporting inpatients admitted to care in other specialties
2022, Revista Portuguesa de Imunoalergologia
Will the asthma revolution fostered by biologics also benefit adult ICU patients?
2021, Allergy: European Journal of Allergy and Clinical Immunology
Time to Asthma-Related Readmission in Children Admitted to the ICU for Asthma
2017, Pediatric Critical Care Medicine
Asthma: Treatment and prevention of pulmonary exacerbations
2017, ERS Monograph

View all citing articles on Scopus

View full text

Original ArticleTrends in hospital admissions due to asthma in north-west Spain from 1995 to 2007

Abstract

Purpose

Methods

Results

Conclusions

Introduction

Section snippets

Material and methods

Results

Discussion

Chest

J Allergy Clin Immunol

J Infect

Environ Res

Allergol Immunopathol (Madr)

J Pediatr.

J Allergy Clin Immunol.

Arch Bronconeumol

An Pediatr (Barc)

Comparison of asthma prevalence in the ISAAC and the ECRHS. ISAAC Steering Committee and the European Community Respiratory Health Survey. International Study of Asthma and Allergies in Childhood

Eur Respir J

Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain

Allergy

Trends in hospitalization for childhood asthma in Finland in 1996–2004

Acta Paediatr.

Hospitalizations for childhood asthma in Athens, Greece, from 1978 to 2000

Pediatr Allergy Immunol

Decrease in childhood asthma admissions in Athens, Greece from 2001 to 2005

Acta Paediatr

50 years of asthma: UK trends from 1955 to 2004

Thorax

Original Article
Trends in hospital admissions due to asthma in north-west Spain from 1995 to 2007