Characteristics of inner-city children with life-threatening asthma

Mary Elizabeth Bollinger, Arlene Manns Butz, Mona Tsoukleris, Cassia Lewis-Land, Shawna S Mudd, Tricia Morphew

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)381-386
Number of pages6
JournalAnnals of Allergy, Asthma and Immunology
Volume122
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Intensive Care Units
Asthma
Allergens
Cotinine
Albuterol
Alternaria
Pediatric Intensive Care Units
Cockroaches
Mites
Medicaid
Serologic Tests
Aspergillus
Poverty
Poaceae
Dust
African Americans
Immunoglobulin E
Patient Care
Cats
Randomized Controlled Trials

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

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 journalArticle

Bollinger, Mary Elizabeth ; Butz, Arlene Manns ; Tsoukleris, Mona ; Lewis-Land, Cassia ; Mudd, Shawna S ; Morphew, Tricia. / Characteristics of inner-city children with life-threatening asthma. In: Annals of Allergy, Asthma and Immunology. 2019 ; Vol. 122, No. 4. pp. 381-386.
@article{0d82447256b248189b5668576b2ba777,
title = "Characteristics of inner-city children with life-threatening asthma",
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.",
author = "Bollinger, {Mary Elizabeth} and Butz, {Arlene Manns} and Mona Tsoukleris and Cassia Lewis-Land and Mudd, {Shawna S} and Tricia Morphew",
year = "2019",
month = "4",
day = "1",
doi = "10.1016/j.anai.2019.02.002",
language = "English (US)",
volume = "122",
pages = "381--386",
journal = "Annals of Allergy, Asthma and Immunology",
issn = "1081-1206",
publisher = "American College of Allergy, Asthma and Immunology",
number = "4",

}

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 -