Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.
Department of Epidemiology, UCLA Fielding School of Public Health, Tokyo, Japan.
Pediatr Allergy Immunol. 2017 Dec;28(8):763-767. doi: 10.1111/pai.12801. Epub 2017 Oct 18.
Asthma and obesity are common health problems in children. This study investigated the impact of obesity on children hospitalized with acute asthma exacerbation.
We obtained the hospital discharge records of inpatients aged 3-8 years with a diagnosis of asthma using a national inpatient database in Japan. The patients were classified into underweight, normal weight, overweight, and obese groups using weight for height and body mass index for age provided by the World Health Organization. We compared 30-day re-admission, need for intensive care, mean total hospitalization costs, and length of hospital stay between the 4 groups using multivariable regression models.
Overall, 38 679 patients were identified, including 3177 underweight, 28 904 normal weight, 3334 overweight, and 3264 obese patients. The obese group showed significantly higher 30-day re-admission (adjusted odds ratio, 1.26; 95% confidence interval, 1.03-1.54) and longer length of stay (adjusted difference, 0.12 days; 95% confidence interval, 0.10-0.20 days) than the normal weight group. The threshold was a 91st percentile of weight for length or body mass index for the relationship with 30-day re-admission. No significant difference was observed between the 4 groups regarding the need for intensive care and total hospitalization costs.
These findings demonstrated that obesity was a risk factor for repeated admissions caused by asthma in children, indicating the importance for the prevention of pediatric obesity.
哮喘和肥胖是儿童常见的健康问题。本研究调查了肥胖对因急性哮喘加重住院的儿童的影响。
我们使用日本全国住院患者数据库，获取了诊断为哮喘的 3-8 岁住院患者的住院记录。根据世界卫生组织提供的身高体重和年龄体重指数，患者被分为体重不足、正常体重、超重和肥胖组。我们使用多变量回归模型比较了 4 组患者的 30 天再入院率、需要重症监护、平均总住院费用和住院时间。
共纳入 38679 例患者，包括体重不足 3177 例、正常体重 28904 例、超重 3334 例和肥胖 3264 例。肥胖组的 30 天再入院率（调整比值比，1.26；95%置信区间，1.03-1.54）和住院时间（调整差异，0.12 天；95%置信区间，0.10-0.20 天）明显高于正常体重组。体重与长度的第 91 百分位或体重与年龄的体重指数与 30 天再入院率有关。4 组患者在需要重症监护和总住院费用方面无显著差异。
这些发现表明肥胖是儿童哮喘反复发作的危险因素，这表明预防儿童肥胖的重要性。
