Cargando…
Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study
BACKGROUND: 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. METHODS: Asthma patients 5‐17 years old wit...
Autores principales: | , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496431/ https://www.ncbi.nlm.nih.gov/pubmed/32115766 http://dx.doi.org/10.1111/pai.13237 |
_version_ | 1783583095586291712 |
---|---|
author | Engelkes, Marjolein Baan, Esme J. de Ridder, Maria A. J. Svensson, Elisabeth Prieto‐Alhambra, Daniel Lapi, Francesco Giaquinto, Carlo Picelli, Gino Boudiaf, Nada Albers, Frank Evitt, Lee A. Cockle, Sarah Bradford, Eric Van Dyke, Melissa K. Suruki, Robert Rijnbeek, Peter Sturkenboom, Miriam C. J. M. Janssens, Hettie M. Verhamme, Katia M. C. |
author_facet | Engelkes, Marjolein Baan, Esme J. de Ridder, Maria A. J. Svensson, Elisabeth Prieto‐Alhambra, Daniel Lapi, Francesco Giaquinto, Carlo Picelli, Gino Boudiaf, Nada Albers, Frank Evitt, Lee A. Cockle, Sarah Bradford, Eric Van Dyke, Melissa K. Suruki, Robert Rijnbeek, Peter Sturkenboom, Miriam C. J. M. Janssens, Hettie M. Verhamme, Katia M. C. |
author_sort | Engelkes, Marjolein |
collection | PubMed |
description | BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. |
format | Online Article Text |
id | pubmed-7496431 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74964312020-09-25 Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study Engelkes, Marjolein Baan, Esme J. de Ridder, Maria A. J. Svensson, Elisabeth Prieto‐Alhambra, Daniel Lapi, Francesco Giaquinto, Carlo Picelli, Gino Boudiaf, Nada Albers, Frank Evitt, Lee A. Cockle, Sarah Bradford, Eric Van Dyke, Melissa K. Suruki, Robert Rijnbeek, Peter Sturkenboom, Miriam C. J. M. Janssens, Hettie M. Verhamme, Katia M. C. Pediatr Allergy Immunol ORIGINAL ARTICLES BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. John Wiley and Sons Inc. 2020-03-20 2020-07 /pmc/articles/PMC7496431/ /pubmed/32115766 http://dx.doi.org/10.1111/pai.13237 Text en © 2020 The Authors. Pediatric Allergy and Immunology published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | ORIGINAL ARTICLES Engelkes, Marjolein Baan, Esme J. de Ridder, Maria A. J. Svensson, Elisabeth Prieto‐Alhambra, Daniel Lapi, Francesco Giaquinto, Carlo Picelli, Gino Boudiaf, Nada Albers, Frank Evitt, Lee A. Cockle, Sarah Bradford, Eric Van Dyke, Melissa K. Suruki, Robert Rijnbeek, Peter Sturkenboom, Miriam C. J. M. Janssens, Hettie M. Verhamme, Katia M. C. Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study |
title | Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study |
title_full | Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study |
title_fullStr | Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study |
title_full_unstemmed | Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study |
title_short | Incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study |
title_sort | incidence, risk factors and re‐exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study |
topic | ORIGINAL ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496431/ https://www.ncbi.nlm.nih.gov/pubmed/32115766 http://dx.doi.org/10.1111/pai.13237 |
work_keys_str_mv | AT engelkesmarjolein incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT baanesmej incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT deriddermariaaj incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT svenssonelisabeth incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT prietoalhambradaniel incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT lapifrancesco incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT giaquintocarlo incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT picelligino incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT boudiafnada incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT albersfrank incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT evittleea incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT cocklesarah incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT bradforderic incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT vandykemelissak incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT surukirobert incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT rijnbeekpeter incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT sturkenboommiriamcjm incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT janssenshettiem incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy AT verhammekatiamc incidenceriskfactorsandreexacerbationrateofsevereasthmaexacerbationsinamultinationalmultidatabasepediatriccohortstudy |