Spencer N, Logan S, Scholey S, Gentle S
Centre for Community and Social Paediatric Research, University of Warwick, Coventry.
Arch Dis Child. 1996 Jan;74(1):50-2. doi: 10.1136/adc.74.1.50.
To test the hypothesis that socioeconomic deprivation is associated with an increased risk of admission with clinically suspected bronchiolitis.
Case-control study.
Children under 1 year living in Sheffield in 1989-90.
307 children resident in Sheffield admitted to Sheffield hospitals with clinically suspected bronchiolitis between 1 October 1989 and 28 February 1990.
Children admitted with clinically suspected bronchiolitis were ascertained from laboratory records of nasopharyngeal aspirates cultured for respiratory syncytial virus. Case notes were examined to determine whether these children had required medical intervention and postcode of residence was recorded. Controls were selected from the Sheffield child development study (SCDS) data. Postcodes were converted to electoral wards which were assigned Townsend deprivation index scores. Electoral wards were then categorised by Townsend score into five levels of deprivation. Data on family smoking for cases and controls were extracted from the SCDS.
Of the 307 children admitted with suspected bronchiolitis during the study period, 127 required one or more medical intervention. The risk of admission with clinically suspected bronchiolitis and with bronchiolitis requiring medical intervention rose with increasing level of deprivation score of electoral ward of residence. Children living in electoral wards in the two more deprived groups were more than 1.5 times as likely to be admitted (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.25 to 2.24) or admitted requiring a medical intervention (OR 1.74, 95% CI 1.16 to 2.62) than children living in other parts of the city. Similar results were obtained after exclusion of children living in homes classified as smoky by the health visitor.
Residence in an area of social and material deprivation increases the risk of admission with bronchiolitis even after taking account of parental smoking and when only more severe cases were considered.
检验社会经济剥夺与临床疑似细支气管炎入院风险增加相关这一假设。
病例对照研究。
1989 - 1990年居住在谢菲尔德的1岁以下儿童。
1989年10月1日至1990年2月28日期间因临床疑似细支气管炎入住谢菲尔德医院的307名居住在谢菲尔德的儿童。
从呼吸道合胞病毒培养的鼻咽抽吸物实验室记录中确定临床疑似细支气管炎入院的儿童。检查病历以确定这些儿童是否需要医疗干预，并记录居住邮政编码。对照组从谢菲尔德儿童发育研究（SCDS）数据中选取。邮政编码转换为选举选区，这些选区被赋予汤森德剥夺指数得分。然后根据汤森德得分将选举选区分为五个剥夺水平类别。病例组和对照组的家庭吸烟数据从SCDS中提取。
在研究期间因疑似细支气管炎入院的307名儿童中，127名需要一次或多次医疗干预。临床疑似细支气管炎入院以及需要医疗干预的细支气管炎入院风险随着居住选举选区剥夺得分水平的增加而上升。居住在两个更贫困组选举选区的儿童入院（比值比（OR）1.67，95%置信区间（CI）1.25至2.24）或因需要医疗干预而入院（OR 1.74，95%CI 1.16至2.62）的可能性是居住在城市其他地区儿童的1.5倍以上。在排除健康访视员分类为烟雾弥漫家庭中的儿童后，获得了类似结果。
即使考虑到父母吸烟情况且仅考虑更严重的病例，居住在社会和物质剥夺地区也会增加细支气管炎入院风险。
