Engelkes M, Janssens H M, de Ridder M A J, Sturkenboom M C J M, de Jongste J C, Verhamme K M C
Department of Medical Informatics, Erasmus MC, Rotterdam, The Netherlands.
Department of Paediatrics, Division Respiratory Medicine and Allergology, Erasmus MC/Sophia Children's Hospital, Rotterdam, The Netherlands.
Respir Med. 2016 Oct;119:48-54. doi: 10.1016/j.rmed.2016.08.016. Epub 2016 Aug 23.
Real-life data on the incidence rates (IR) and risk factors of severe asthma exacerbations in children are sparse. We aimed to assess IR and risk factors of severe asthma exacerbations in children in real life. We conducted a population-based cohort study using a Dutch GP database containing complete medical records of >1 million patients. All records of children with physician-diagnosed asthma aged 5-18 years between 2000 and 2012 were examined for exacerbations, defined as either hospitalization, emergency department visit or need of systemic steroids for asthma. IR was expressed as number of exacerbations per person year (PY). We identified 14,303 asthmatic children with 35,118 PY of follow-up and 732 exacerbations. The overall IR was 2.1/100PY (95% CI 1.9-2.2), 4.1/100PY (3.8-4.4) for children on asthma treatment. Re-exacerbation occurred in 2% (1.3-4.3) of patients within 1 month, in 25% (20.6-28.8) within 1 year. Predictors for (frequent) exacerbations were age, medication use and prior exacerbations (all p < 0.001). The overall IR of severe asthma exacerbations was 4/100PY in children on asthma treatment, highest in spring and fall. 25% of the patients with an exacerbation will experience a next exacerbation within 1 year. More severe asthma is a predictor of subsequent and future exacerbations.
关于儿童严重哮喘急性发作的发病率（IR）和风险因素的实际数据很少。我们旨在评估现实生活中儿童严重哮喘急性发作的发病率和风险因素。我们使用了一个荷兰全科医生数据库进行了一项基于人群的队列研究，该数据库包含超过100万患者的完整医疗记录。对2000年至2012年间年龄在5至18岁、经医生诊断为哮喘的儿童的所有记录进行了急性发作检查，急性发作定义为因哮喘住院、急诊就诊或需要全身使用类固醇。发病率以每人每年（PY）的急性发作次数表示。我们确定了14303名哮喘儿童，随访时间为35118人年，发生了732次急性发作。总体发病率为2.1/100人年（95%CI 1.9 - 2.2），接受哮喘治疗的儿童为4.1/100人年（3.8 - 4.4）。2%（1.3 - 4.3）的患者在1个月内再次发作，25%（20.6 - 28.8）在1年内再次发作。（频繁）急性发作的预测因素是年龄、药物使用和既往急性发作（所有p < 0.001）。接受哮喘治疗的儿童严重哮喘急性发作的总体发病率为4/100人年，在春季和秋季最高。25%的急性发作患者将在1年内经历下一次急性发作。更严重的哮喘是后续和未来急性发作的预测因素。
