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儿童哮喘和过敏对日常生活、健康结果和医疗保健服务使用的影响:一项基于人群的研究。

Prevalence and Impact of Asthma and Allergy on Daily Life, Health Outcomes and Use of Healthcare Services in Children: A Population-Based Study.

机构信息

Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain; Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

Department of Pediatric Allergy, Parc Taulí University Hospital, Sabadell, Spain; Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell Spain.

出版信息

Arch Bronconeumol. 2023 Aug;59(8):481-487. doi: 10.1016/j.arbres.2023.05.005. Epub 2023 May 24.

Abstract

INTRODUCTION

Studies on the prevalence of asthma and allergies often lack representation of the pediatric population, and their impact has not been examined using children without these diseases as a reference group. This study aimed to determine the prevalence of asthma and allergies in children under 14 years old in Spain and their impact on health-related quality of life, activities, healthcare utilization, and environmental and household exposure risk factors.

METHODS

Data came from a Spanish population-based representative survey of children aged <14 years (N=6297). A sample of controls (1:4) from the same survey was matched using propensity score matching. Logistic regression models and population-attributable fractions were calculated to determine the impact of asthma and allergy.

RESULTS

The population prevalence of asthma was 5.7% (95% CI: 5.0%, 6.4%), and of allergy was 11.4% (95% CI: 10.5%, 12.4. In children with lower percentiles of health-related quality of life (≤20th), 32.3% (95% CI, 13.6%, 47.0%) was attributed to asthma and 27.7% (95% CI: 13.0%, 40.0%) to allergy. Forty-four percent of restrictions in usual activity were attributed to asthma (OR: 2.0, p-value: <0.001), and 47.9% to allergy (OR: 2.1, p-value: <0.001). 62.3% of all hospital admissions were attributed to asthma (OR: 2.8, p-value: <0.001), and 36.8% (OR: 2.5, p-value: <0.001) of all specialist consults to allergy.

CONCLUSIONS

The high prevalence of atopic disease and its impact on daily life and healthcare utilization call for an integrated healthcare system focused on children and caregivers' needs with continuity of care across education and healthcare settings.

摘要

简介

哮喘和过敏的研究通常缺乏儿科人群的代表性,并且尚未使用没有这些疾病的儿童作为参考组来检查其影响。本研究旨在确定西班牙 14 岁以下儿童哮喘和过敏的患病率,以及它们对健康相关生活质量、活动、医疗保健利用以及环境和家庭暴露危险因素的影响。

方法

数据来自一项针对 <14 岁儿童的西班牙基于人群的代表性调查(N=6297)。使用倾向评分匹配从同一调查中匹配了对照组(1:4)。计算了逻辑回归模型和人群归因分数,以确定哮喘和过敏的影响。

结果

哮喘的人群患病率为 5.7%(95%CI:5.0%,6.4%),过敏的患病率为 11.4%(95%CI:10.5%,12.4%)。在健康相关生活质量百分位较低的儿童(≤20%)中,32.3%(95%CI,13.6%,47.0%)归因于哮喘,27.7%(95%CI:13.0%,40.0%)归因于过敏。44%的日常活动受限归因于哮喘(OR:2.0,p 值:<0.001),47.9%归因于过敏(OR:2.1,p 值:<0.001)。所有住院治疗的 62.3%归因于哮喘(OR:2.8,p 值:<0.001),所有专科咨询的 36.8%归因于过敏(OR:2.5,p 值:<0.001)。

结论

特应性疾病的高患病率及其对日常生活和医疗保健利用的影响要求建立一个以儿童和照顾者的需求为中心的综合医疗保健系统,在教育和医疗保健环境中提供连续性的医疗保健。

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