Columbia University, Mailman School of Public Health, Department of Environmental Health Sciences, 722 West 168th Street, New York, NY 10032, USA.
Columbia University Medical Center, Pediatric Pulmonary Division, 3959 Broadway, Room CHC-745, New York, NY 10032, USA.
Respir Med. 2018 Feb;135:42-50. doi: 10.1016/j.rmed.2018.01.005. Epub 2018 Jan 10.
Exercise-induced wheeze (EIW) has been found to be associated with asthma-related urgent care in school-aged children. Despite asthma's high prevalence and morbidity among adolescents, this association has not been examined in adolescents. We tested the association of EIW and other asthma symptoms to asthma-related ED visits and hospitalizations in urban adolescents with probable asthma. We hypothesized that EIW would be associated with urgent care.
In this cross-sectional study 30,467 high school students (mean age = 16.0) from 49 NYC schools completed two brief validated measures, one assessing probable asthma and the other the frequency of six asthma symptoms over the past year. Adolescents also reported if in the past year they had an asthma-related ED visit or hospitalization. Analyses presented here included students with probable asthma (n = 9149). Using logistic regression, we modeled each asthma symptom as a function of ED visits and hospitalizations adjusting for sex, age, race/ethnicity and asthma severity. Multivariable models included all symptoms to account for the potential interaction between symptoms.
Among adolescents with probable asthma, EIW was associated with ED visits and hospitalizations. In multivariable models wheeze without a cold, chest tightness, night wakening, but not EIW, were significantly associated with both ED visits and hospitalizations.
Unlike findings with younger children, EIW does not appear to be associated with ED visits and hospitalizations among urban adolescents with probable asthma. Instead, symptoms, such as chest tightness and night wakening, appear to be important at identifying adolescents at risk for asthma-related urgent care.
运动诱发的喘息（EIW）与学龄儿童的哮喘相关紧急护理有关。尽管青少年哮喘的发病率和发病率很高，但尚未在青少年中对此进行研究。我们测试了 EIW 和其他哮喘症状与城市青少年哮喘患者的哮喘相关急诊就诊和住院的关系。我们假设 EIW 与紧急护理有关。
在这项横断面研究中，来自纽约市 49 所学校的 30467 名高中生（平均年龄为 16.0 岁）完成了两项简短的验证性措施，一项评估了可能的哮喘，另一项评估了过去一年中六种哮喘症状的频率。青少年还报告了过去一年是否有哮喘相关的急诊就诊或住院。这里呈现的分析包括患有可能的哮喘的学生（n=9149）。使用逻辑回归，我们将每个哮喘症状作为急诊就诊和住院的函数进行建模，调整了性别、年龄、种族/族裔和哮喘严重程度。多变量模型包括所有症状，以考虑症状之间的潜在相互作用。
在患有可能的哮喘的青少年中，EIW 与急诊就诊和住院有关。在多变量模型中，无感冒的喘息、胸闷、夜间醒来，但 EIW 除外，与急诊就诊和住院均显著相关。
与年龄较小的儿童的研究结果不同，EIW 似乎与城市青少年中可能的哮喘患者的急诊就诊和住院无关。相反，症状，如胸闷和夜间醒来，似乎对于识别有哮喘相关紧急护理风险的青少年很重要。
