Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada.
Department of Statistics, The University of British Columbia, Vancouver, British Columbia, Canada.
Ann Allergy Asthma Immunol. 2022 Oct;129(4):475-480.e2. doi: 10.1016/j.anai.2022.06.022. Epub 2022 Jun 30.
Asthma hospitalizations declined rapidly in many parts of the world, including Canada, in the 1990s and early 2000s.
To examine whether the declining trend of asthma hospitalizations persisted in recent years in Canada.
Using the Canadian comprehensive nationwide hospitalization data (2002-2017), we identified hospital admissions with the main International Classification of Diseases codes for asthma. We analyzed sex-specific age-standardized trends in annual hospitalization rates among pediatric (< 19 years) and adult (19+ years) patients. We used change-point analysis to evaluate any substantial changes in the trends in the sex-age groups.
There were 254,672 asthma-related hospital admissions (59% pediatric, 50% female) during the study period. Among children, age-adjusted annual rates per 100,000 decreased by 55% in females (152-69) and by 60% in males (270-108) from 2002 to 2017. Among adults, the rates decreased by 59% in both sexes (females: 61-25; males: 27-11). Change-point analysis indicated a substantial plateauing of the annual rate in both pediatric (from -15.3 [females] and -25.8 [males] before 2010 to -0.6 [females] and -0.8 [males] after 2010) and adult (from -5.4 [females] and -2.6 [males] before 2008 to -0.6 [females] and -0.2 [males] after 2008) groups.
After a substantial decline in hospital admissions for acute asthma, there has been minimal further decline since 2010 for children and 2008 for adults. In addition to adhering to the contemporary standards of asthma care, novel, disruptive strategies are likely needed to further reduce the burden of asthma.
在 20 世纪 90 年代和本世纪初，包括加拿大在内的世界许多地区的哮喘住院率迅速下降。
检查近年来加拿大哮喘住院率下降的趋势是否持续。
利用加拿大全面的全国住院数据（2002-2017 年），我们确定了主要国际疾病分类代码为哮喘的住院病例。我们分析了儿科（<19 岁）和成年（19+岁）患者中每年住院率的性别标准化趋势。我们使用变化点分析来评估这些性别-年龄组的趋势是否发生了实质性变化。
在研究期间，有 254672 例与哮喘相关的住院病例（59%为儿科患者，50%为女性）。在儿童中，2002 年至 2017 年，女性（152-69 岁）和男性（270-108 岁）的年龄调整后每年每 10 万人的发病率分别下降了 55%和 60%。在成年人中，两性的发病率均下降了 59%（女性：61-25；男性：27-11）。变化点分析表明，儿科（从 2010 年前每年 -15.3%[女性]和-25.8%[男性]到 2010 年后每年 -0.6%[女性]和-0.8%[男性]）和成年（从 2008 年前每年 -5.4%[女性]和-2.6%[男性]到 2008 年后每年 -0.6%[女性]和-0.2%[男性]）两组的年发病率都出现了实质性的平稳。
在急性哮喘住院人数大幅下降之后，自 2010 年以来，儿童的下降幅度较小，自 2008 年以来，成年人的下降幅度较小。除了坚持当前的哮喘护理标准外，可能还需要新的、颠覆性的策略来进一步降低哮喘的负担。
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