Department of Pediatric Intensive Care, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands.
Respir Care. 2012 Sep;57(9):1391-7. doi: 10.4187/respcare.01325. Epub 2012 Feb 17.
Severe acute asthma in children is associated with substantial morbidity and may require pediatric ICU (PICU) admission. The aim of the study was to determine risk factors for PICU admission.
The study used a retrospective multicenter case-control design. The cases included children admitted to the PICU because of severe acute asthma and a history of out-patient treatment by pediatricians or pediatric pulmonologists. Controls were children with asthma without a PICU admission for severe acute asthma. The children were matched for sex, age, hospital, and time elapsed since the diagnosis of asthma. Fourteen possible risk factors were analyzed.
Sixty-six cases were matched to 164 controls. In univariate analysis, all but one of the analyzed variables were significantly associated with PICU-hospitalization. After multivariate conditional logistic regression analysis, 4 risk factors remained significant. These included active or passive smoking, allergies, earlier hospitalization for asthma, and non-sanitized home.
Physicians and parents should be aware of these risk factors, and efforts should be made to counteract them.
儿童严重急性哮喘与较高的发病率相关,可能需要入住儿科重症监护病房(PICU)。本研究旨在确定儿童入住 PICU 的危险因素。
本研究采用回顾性多中心病例对照设计。病例组纳入因严重急性哮喘并曾在儿科医生或儿科肺科医生处接受门诊治疗而入住 PICU 的儿童。对照组为因严重急性哮喘而未入住 PICU 的哮喘儿童。将这些儿童按照性别、年龄、医院和哮喘诊断后时间进行匹配。分析了 14 个可能的危险因素。
共纳入 66 例病例和 164 例对照。在单因素分析中,除 1 个变量外,所有分析变量均与 PICU 住院显著相关。多变量条件逻辑回归分析后,有 4 个危险因素仍然显著,包括主动或被动吸烟、过敏、哮喘早期住院和非消毒家庭。
医生和家长应了解这些危险因素,并努力加以应对。