Herrera A M, Brand P, Cavada G, Koppmann A, Rivas M, Mackenney J, Sepúlveda H, Wevar M E, Cruzat L, Soto S, Pérez M A, León A, Contreras I, Alvarez C, Walker B, Flores C, Lezana V, Garrido C, Herrera M E, Rojas A, Andrades C, Chala E, Martínez R A, Vega M, Perillán J A, Seguel H, Przybyzsweski I
Santa María Clinic, Santa María 500, Santiago 7520378, Región Metropolitana, Chile; School of Medicine, Los Andes University, Monseñor Alvaro del Portillo 12455, Santiago 7620001, Región Metropolitana, Chile.
Isala Women's and Children's Hospital, Zwolle, The Netherlands.
Allergol Immunopathol (Madr). 2018 Nov-Dec;46(6):533-538. doi: 10.1016/j.aller.2018.02.006. Epub 2018 Apr 30.
Asthma hospitalization rates in Chilean children have increased in the last 14 years, but little is known about the factors associated with this.
Describe clinical characteristics of children hospitalized for asthma exacerbation.
Observational prospective cohort study in 14 hospitals. Over a one-year period, children five years of age or older hospitalized with asthma exacerbation were eligible for inclusion. Parents completed an online questionnaire with questions on demographic information, about asthma, indoor environmental contaminant exposure, comorbidities and beliefs about disease and treatment. Disease control was assessed by the Asthma Control Test. Inhalation technique was observed using a checklist.
396 patients were enrolled. 168 children did not have an established diagnosis of asthma. Only 188 used at least one controller treatment at the time of hospitalization. 208 parents said they believed their child had asthma only when they had an exacerbation and 97 correctly identified inhaled corticosteroids as anti-inflammatory treatment. 342 patients used the wrong spacer and 73 correctly performed all steps of the checklist.
Almost half of the patients were not diagnosed with asthma at the time of hospitalization despite having a medical history suggestive of the disease. In the remaining patients with an established diagnosis of asthma potentially modifiable factors like bad adherence to treatment and poor inhalation technique were found. Implementing a nationwide asthma program including continued medical education for the correct diagnosis and follow up of these patients and asthma education for patients and caregivers is needed to reduce asthma hospitalization rates in Chilean children.
在过去14年中，智利儿童哮喘住院率有所上升，但对此相关因素知之甚少。
描述因哮喘急性加重住院的儿童的临床特征。
在14家医院进行观察性前瞻性队列研究。在一年时间里，5岁及以上因哮喘急性加重住院的儿童符合纳入标准。家长完成一份在线问卷，内容涉及人口统计学信息、哮喘、室内环境污染物暴露、合并症以及对疾病和治疗的看法。通过哮喘控制测试评估疾病控制情况。使用检查表观察吸入技术。
共纳入396例患者。168名儿童未确诊哮喘。只有188名患者在住院时至少使用了一种控制药物治疗。208名家长表示他们认为孩子只有在急性加重时才患有哮喘，97名家长正确识别吸入性糖皮质激素为抗炎治疗药物。342名患者使用了错误的储雾罐，73名患者正确完成了检查表上的所有步骤。
尽管有提示疾病的病史，但近一半患者在住院时未被诊断为哮喘。在其余确诊哮喘的患者中，发现了一些潜在可改变的因素，如治疗依从性差和吸入技术不佳。需要实施一项全国性哮喘计划，包括对这些患者进行正确诊断和随访的继续医学教育，以及对患者和护理人员进行哮喘教育，以降低智利儿童哮喘住院率。
