Han Peng, Jiao Anxia, Yin Ju, Zou Huimin, Liu Yuliang, Li Zheng, Wang Quan, Wu Jie, Shen Kunling
Respiratory Department, China National Clinical Research Center of Respiratory Diseases, Beijing, China, Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Interventional Pulmonology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.
Front Pediatr. 2024 Jan 15;11:1335540. doi: 10.3389/fped.2023.1335540. eCollection 2023.
To describe the proportion and clinical characteristics of hospitalized children with acute asthma attacks complicated by respiratory failure and to analyze the risk factors.
This retrospective study analyzed hospital admissions of children and adolescents with acute asthma attacks between January 2016 and December 2021. Inclusion criteria were used to identify eligible cases, and demographic information and disease characteristics were collected. Patients were categorized into respiratory failure group and the other group based on the result of artery blood gas analysis. Multivariate logistic regression was utilized to investigate the risk factors associated with respiratory failure resulting from acute asthma attacks. The data were analyzed using SPSS 22.0, and significance was considered at < 0.05.
Our research involved 225 participants, with 18.7% diagnosed with respiratory failure. The respiratory failure group was found to be younger and have higher percentage of male, while birth weight, nationality, and type of residence did not differ between the two groups. In the respiratory failure group, a significant difference was observed in emergency hospitalization, ICU treatment, severe to critical attack, dyspnea and allergy history. The two groups did not differ in admission season, first asthma diagnosis, respiratory infection and comorbidity. The respiratory failure group exhibited a higher proportion of atopy-only asthma and a lower proportion of T2-high asthma. The eosinophil count, and eosinophil percentage were lower in the respiratory failure group, while neutrophil count was higher. Having a history of allergies (OR = 2.46, 95% CI: 1.08-5.59) and neutrophil count (OR = 1.10, 95% CI: 1.00-1.21) were the risk factors for respiratory failure in children with asthma. There also existed that the risk of respiratory failure increases with decreasing age of the children (OR = 0.85, 95% CI: 0.73-0.99).
Notably, risk factors for respiratory failure in hospitalized asthma children include age, having a history of allergies, and neutrophil count. The identification of the above factors and the implementation of timely intervention can optimize the treatment of asthma in children.
描述急性哮喘发作并发呼吸衰竭住院儿童的比例及临床特征，并分析危险因素。
本回顾性研究分析了2016年1月至2021年12月期间因急性哮喘发作住院的儿童和青少年。采用纳入标准确定符合条件的病例，并收集人口统计学信息和疾病特征。根据动脉血气分析结果将患者分为呼吸衰竭组和其他组。采用多因素logistic回归分析急性哮喘发作导致呼吸衰竭的危险因素。使用SPSS 22.0对数据进行分析，以<0.05为差异有统计学意义。
本研究共纳入225名参与者，其中18.7%被诊断为呼吸衰竭。发现呼吸衰竭组年龄更小，男性比例更高，而两组之间的出生体重、国籍和居住类型无差异。呼吸衰竭组在急诊住院、ICU治疗、重度至危重度发作、呼吸困难及过敏史方面存在显著差异。两组在入院季节、首次哮喘诊断、呼吸道感染及合并症方面无差异。呼吸衰竭组中单纯特应性哮喘比例较高，T2高哮喘比例较低。呼吸衰竭组嗜酸性粒细胞计数及嗜酸性粒细胞百分比更低，而中性粒细胞计数更高。有过敏史（OR = 2.46，95%CI：1.08 - 5.59）和中性粒细胞计数（OR = 1.10，95%CI：1.00 - 1.21）是哮喘儿童呼吸衰竭的危险因素。还存在呼吸衰竭风险随儿童年龄降低而增加的情况（OR = 0.85，95%CI：0.73 - 0.99）。
值得注意的是，住院哮喘儿童呼吸衰竭的危险因素包括年龄、有过敏史和中性粒细胞计数。识别上述因素并及时进行干预可优化儿童哮喘的治疗。
