Abstract
Background: Intensive care unit (ICU) admission is a risk factor for fatal asthma. Little is known about risk factors for pediatric ICU admissions for asthma. Objective: To examine characteristics of underserved minority children with prior ICU admissions for asthma. Methods: Baseline survey data, salivary cotinine levels, and allergen specific IgE serologic test results were obtained from children with uncontrolled asthma enrolled in a randomized clinical trial of a behavioral education environmental control intervention. Characteristics of children with and without prior ICU admission were compared using χ 2 and t tests. Logistic regression assessed significance of higher odds of prior ICU admission comparing factor-level categories. Results: Patients included 222 primarily African American (93.7%), male (56%), Medicaid-insured (92.8%) children with a mean (SD) age of 6.4 (2.7) years with uncontrolled asthma. Most (57.9%) had detectable cotinine levels, 82.6% were sensitized to more than 1 environmental allergen, and 27.9% had prior ICU admissions. Prior ICU patients were more likely to be very poor (<$10,000 per year) and sensitized to more than 1 allergen tested (most importantly mouse) (P <.05). Allergen sensitization in the groups did not differ for cockroach, cat, dog, Alternaria, Aspergillus, dust mite, grass, or tree. Although more ICU patients received combination controller therapy, they also overused albuterol. Only 27.4% of ICU patients received specialty care in the previous 2 years, which was not significantly different from non-ICU patients. Conclusion: Children with high mortality risk, including history of ICU admission, were twice as likely to live in extreme poverty, have atopy (particularly mouse allergen), use combination controller therapy, and overuse albuterol. Trial Registration: ClinicalTrials.gov Identifier: NCT01981564.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 381-386 |
| Number of pages | 6 |
| Journal | Annals of Allergy, Asthma and Immunology |
| Volume | 122 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2019 |
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ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Pulmonary and Respiratory Medicine
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Characteristics of inner-city children with life-threatening asthma. / Bollinger, Mary Elizabeth; Butz, Arlene Manns; Tsoukleris, Mona; Lewis-Land, Cassia; Mudd, Shawna S; Morphew, Tricia.
In: Annals of Allergy, Asthma and Immunology, Vol. 122, No. 4, 01.04.2019, p. 381-386.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Characteristics of inner-city children with life-threatening asthma
AU - Bollinger, Mary Elizabeth
AU - Butz, Arlene Manns
AU - Tsoukleris, Mona
AU - Lewis-Land, Cassia
AU - Mudd, Shawna S
AU - Morphew, Tricia
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Background: Intensive care unit (ICU) admission is a risk factor for fatal asthma. Little is known about risk factors for pediatric ICU admissions for asthma. Objective: To examine characteristics of underserved minority children with prior ICU admissions for asthma. Methods: Baseline survey data, salivary cotinine levels, and allergen specific IgE serologic test results were obtained from children with uncontrolled asthma enrolled in a randomized clinical trial of a behavioral education environmental control intervention. Characteristics of children with and without prior ICU admission were compared using χ 2 and t tests. Logistic regression assessed significance of higher odds of prior ICU admission comparing factor-level categories. Results: Patients included 222 primarily African American (93.7%), male (56%), Medicaid-insured (92.8%) children with a mean (SD) age of 6.4 (2.7) years with uncontrolled asthma. Most (57.9%) had detectable cotinine levels, 82.6% were sensitized to more than 1 environmental allergen, and 27.9% had prior ICU admissions. Prior ICU patients were more likely to be very poor (<$10,000 per year) and sensitized to more than 1 allergen tested (most importantly mouse) (P <.05). Allergen sensitization in the groups did not differ for cockroach, cat, dog, Alternaria, Aspergillus, dust mite, grass, or tree. Although more ICU patients received combination controller therapy, they also overused albuterol. Only 27.4% of ICU patients received specialty care in the previous 2 years, which was not significantly different from non-ICU patients. Conclusion: Children with high mortality risk, including history of ICU admission, were twice as likely to live in extreme poverty, have atopy (particularly mouse allergen), use combination controller therapy, and overuse albuterol. Trial Registration: ClinicalTrials.gov Identifier: NCT01981564.
AB - Background: Intensive care unit (ICU) admission is a risk factor for fatal asthma. Little is known about risk factors for pediatric ICU admissions for asthma. Objective: To examine characteristics of underserved minority children with prior ICU admissions for asthma. Methods: Baseline survey data, salivary cotinine levels, and allergen specific IgE serologic test results were obtained from children with uncontrolled asthma enrolled in a randomized clinical trial of a behavioral education environmental control intervention. Characteristics of children with and without prior ICU admission were compared using χ 2 and t tests. Logistic regression assessed significance of higher odds of prior ICU admission comparing factor-level categories. Results: Patients included 222 primarily African American (93.7%), male (56%), Medicaid-insured (92.8%) children with a mean (SD) age of 6.4 (2.7) years with uncontrolled asthma. Most (57.9%) had detectable cotinine levels, 82.6% were sensitized to more than 1 environmental allergen, and 27.9% had prior ICU admissions. Prior ICU patients were more likely to be very poor (<$10,000 per year) and sensitized to more than 1 allergen tested (most importantly mouse) (P <.05). Allergen sensitization in the groups did not differ for cockroach, cat, dog, Alternaria, Aspergillus, dust mite, grass, or tree. Although more ICU patients received combination controller therapy, they also overused albuterol. Only 27.4% of ICU patients received specialty care in the previous 2 years, which was not significantly different from non-ICU patients. Conclusion: Children with high mortality risk, including history of ICU admission, were twice as likely to live in extreme poverty, have atopy (particularly mouse allergen), use combination controller therapy, and overuse albuterol. Trial Registration: ClinicalTrials.gov Identifier: NCT01981564.
UR - http://www.scopus.com/inward/record.url?scp=85063394852&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063394852&partnerID=8YFLogxK
U2 - 10.1016/j.anai.2019.02.002
DO - 10.1016/j.anai.2019.02.002
M3 - Article
C2 - 30742915
AN - SCOPUS:85063394852
VL - 122
SP - 381
EP - 386
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
SN - 1081-1206
IS - 4
ER -