Vicendese Don, Dharmage Shyamali C, Tang Mimi L K, Olenko Andriy, Allen Katrina J, Abramson Michael J, Erbas Bircan
a School of Public Health, La Trobe University , Bundoora , Australia .
J Asthma. 2015 Sep;52(7):727-31. doi: 10.3109/02770903.2014.1001904. Epub 2015 Feb 27.
Indoor environment factors have been associated with risk of asthma exacerbations in children but little is known about their role on asthma hospital readmissions. As children in Western societies continually spend more time indoors, understanding the influence of these factors on asthma exacerbation is important. We examined the role of indoor environmental and lifestyle characteristics on child asthma readmissions.
A hospital-based case-control study recruited 22 children readmitted for asthma and 22 controls not readmitted for asthma. Logistic regression models were used to examine the association between aeroallergens and fungi in the bedroom and indoor lifestyle characteristics factors for asthma readmissions. To determine the best possible set of predictors among a large set of risk factors, we used random forests (RF) techniques.
Higher levels of airborne Cladosporium and yeast in the child's bedroom increased risk of readmission (OR = 1.68, 95% CI 1.04-2.72 and OR = 1.52, 95% CI 0.99-2.34, respectively). Carpeted floors in the bedroom and synthetic doonas were also associated with increase in asthma readmissions (OR = 4.07, 95% CI 1.03-16.06 and OR = 14.6, 95% CI 1.26-169.4, respectively). In the home, frequent vacuuming using bagged cleaners increased risk of asthma readmission OR = 15.7 (95% CI 2.82-87.2).
Factors in the child's bedroom play an important role in increasing the risk of asthma hospital readmissions. These findings have major clinical implications as the identified potential risk factors may be modifiable. Further epidemiological studies with larger samples are necessary to evaluate these associations further.
室内环境因素与儿童哮喘发作风险相关,但关于它们在哮喘住院再入院方面的作用知之甚少。由于西方社会的儿童在室内的时间持续增加,了解这些因素对哮喘发作的影响很重要。我们研究了室内环境和生活方式特征对儿童哮喘再入院的作用。
一项基于医院的病例对照研究招募了22名因哮喘再次入院的儿童和22名未因哮喘再次入院的对照。使用逻辑回归模型来研究卧室中的空气过敏原和真菌与哮喘再入院的室内生活方式特征因素之间的关联。为了在大量风险因素中确定最佳可能的预测因素集,我们使用了随机森林(RF)技术。
儿童卧室中较高水平的枝孢菌属和酵母菌会增加再入院风险(分别为OR = 1.68,95% CI 1.04 - 2.72和OR = 1.52,95% CI 0.99 - 2.34)。卧室中的地毯地板和合成被褥也与哮喘再入院增加有关(分别为OR = 4.07,95% CI 1.03 - 16.06和OR = 14.6,95% CI 1.26 - 169.4)。在家里,使用带袋式吸尘器频繁吸尘会增加哮喘再入院风险,OR = 15.7(95% CI 2.82 - 87.2)。
儿童卧室中的因素在增加哮喘住院再入院风险方面起着重要作用。这些发现具有重大临床意义,因为所确定的潜在风险因素可能是可改变的。需要进一步进行更大样本的流行病学研究来进一步评估这些关联。