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Factors associated with exacerbations among adults with asthma according to electronic health record data

BACKGROUND: Asthma is a chronic inflammatory lung disease that affects 18.7 million U.S. adults. Electronic health records (EHRs) are a unique source of information that can be leveraged to understand factors associated with asthma in real-life populations. In this study, we identify demographic fac...

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Autores principales: Greenblatt, Rebecca E., Zhao, Edward J., Henrickson, Sarah E., Apter, Andrea J., Hubbard, Rebecca A., Himes, Blanca E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339400/
https://www.ncbi.nlm.nih.gov/pubmed/30680222
http://dx.doi.org/10.1186/s40733-019-0048-y
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author Greenblatt, Rebecca E.
Zhao, Edward J.
Henrickson, Sarah E.
Apter, Andrea J.
Hubbard, Rebecca A.
Himes, Blanca E.
author_facet Greenblatt, Rebecca E.
Zhao, Edward J.
Henrickson, Sarah E.
Apter, Andrea J.
Hubbard, Rebecca A.
Himes, Blanca E.
author_sort Greenblatt, Rebecca E.
collection PubMed
description BACKGROUND: Asthma is a chronic inflammatory lung disease that affects 18.7 million U.S. adults. Electronic health records (EHRs) are a unique source of information that can be leveraged to understand factors associated with asthma in real-life populations. In this study, we identify demographic factors and comorbidities associated with asthma exacerbations among adults according to EHR-derived data and compare these findings to those of epidemiological studies. METHODS: We obtained University of Pennsylvania Hospital System EHR-derived data for asthma encounters occurring between 2011 and 2014. Regression analyses were performed to model asthma exacerbation frequency as explained by age, sex, race/ethnicity, health insurance type, smoking status, body mass index (BMI) and various comorbidities. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2012 to compare findings with those from the EHR-derived data. RESULTS: Based on data from 9068 adult patients with asthma, 33.37% had at least one exacerbation over the four-year study period. In a proportional odds logistic regression predicting number of exacerbations during the study period (levels: 0, 1–2, 3–4, 5+ exacerbations), after controlling for age, race/ethnicity, sex, health insurance type, and smoking status, the highest odds ratios (ORs) of significantly associated factors were: chronic bronchitis (2.70), sinusitis (1.50), emphysema (1.39), fluid and electrolyte disorders (1.35), class 3 obesity (1.32), and diabetes (1.28). An analysis of NHANES data showed associations for class 3 obesity, anemia and chronic bronchitis with exacerbation frequency in an adjusted model controlling for age, race/ethnicity, sex, financial class and smoking status. CONCLUSIONS: EHR-derived data is helpful to understand exacerbations in real-life asthma patients, facilitating design of detailed studies and interventions tailored for specific populations. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40733-019-0048-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-63394002019-01-24 Factors associated with exacerbations among adults with asthma according to electronic health record data Greenblatt, Rebecca E. Zhao, Edward J. Henrickson, Sarah E. Apter, Andrea J. Hubbard, Rebecca A. Himes, Blanca E. Asthma Res Pract Research BACKGROUND: Asthma is a chronic inflammatory lung disease that affects 18.7 million U.S. adults. Electronic health records (EHRs) are a unique source of information that can be leveraged to understand factors associated with asthma in real-life populations. In this study, we identify demographic factors and comorbidities associated with asthma exacerbations among adults according to EHR-derived data and compare these findings to those of epidemiological studies. METHODS: We obtained University of Pennsylvania Hospital System EHR-derived data for asthma encounters occurring between 2011 and 2014. Regression analyses were performed to model asthma exacerbation frequency as explained by age, sex, race/ethnicity, health insurance type, smoking status, body mass index (BMI) and various comorbidities. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2012 to compare findings with those from the EHR-derived data. RESULTS: Based on data from 9068 adult patients with asthma, 33.37% had at least one exacerbation over the four-year study period. In a proportional odds logistic regression predicting number of exacerbations during the study period (levels: 0, 1–2, 3–4, 5+ exacerbations), after controlling for age, race/ethnicity, sex, health insurance type, and smoking status, the highest odds ratios (ORs) of significantly associated factors were: chronic bronchitis (2.70), sinusitis (1.50), emphysema (1.39), fluid and electrolyte disorders (1.35), class 3 obesity (1.32), and diabetes (1.28). An analysis of NHANES data showed associations for class 3 obesity, anemia and chronic bronchitis with exacerbation frequency in an adjusted model controlling for age, race/ethnicity, sex, financial class and smoking status. CONCLUSIONS: EHR-derived data is helpful to understand exacerbations in real-life asthma patients, facilitating design of detailed studies and interventions tailored for specific populations. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40733-019-0048-y) contains supplementary material, which is available to authorized users. BioMed Central 2019-01-18 /pmc/articles/PMC6339400/ /pubmed/30680222 http://dx.doi.org/10.1186/s40733-019-0048-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Greenblatt, Rebecca E.
Zhao, Edward J.
Henrickson, Sarah E.
Apter, Andrea J.
Hubbard, Rebecca A.
Himes, Blanca E.
Factors associated with exacerbations among adults with asthma according to electronic health record data
title Factors associated with exacerbations among adults with asthma according to electronic health record data
title_full Factors associated with exacerbations among adults with asthma according to electronic health record data
title_fullStr Factors associated with exacerbations among adults with asthma according to electronic health record data
title_full_unstemmed Factors associated with exacerbations among adults with asthma according to electronic health record data
title_short Factors associated with exacerbations among adults with asthma according to electronic health record data
title_sort factors associated with exacerbations among adults with asthma according to electronic health record data
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339400/
https://www.ncbi.nlm.nih.gov/pubmed/30680222
http://dx.doi.org/10.1186/s40733-019-0048-y
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