Pediatric Resident Physician University of Michigan University of Michigan Ann Arbor, Michigan, United States
Background: Asthma affects 1 in 12 children under the age of 17 years, making it the most common chronic respiratory disease in childhood. Despite recent reports of decreasing prevalence, it is still, however, a leading cause for emergency department visits and child hospitalizations.
Objective: To evaluate the trend of overall hospitalizations, associated medical technology use, and outcomes between 2006 and 2016 among children with asthma.
Design/Methods: Retrospective study of children 0-20 years old hospitalized for treatment of asthma between 2006 and 2016 using the Kids' Inpatient Database. Descriptive analysis was performed to determine national estimates of the overall count of hospitalizations, patient and hospital characteristics, medical technology use, duration of hospitalization, hospital charges and in-hospital mortality.
Results: There were 395,058, 434,924, 397,525, and 330,525 hospitalizations nationally for asthma in 2006, 2009, 2012, and 2016, respectively. Across the years, more males were hospitalized with a bi-modal peak in age distribution at 1-5 years and 16-20 years. The proportion of children with comorbidities and extreme illness severity increased over the years of study, with the majority of hospitalizations occurring at urban teaching hospitals in the South census region, most often among children residing in zip codes with the lowest median household income. Insurance coverage was predominantly via public insurance. Associated with the increase in illness severity over time was a concomitant increase in the deployment of medical technology including central venous catheterization, tracheostomy, invasive and non-invasive mechanical ventilation, continuous renal replacement therapy and extracorporeal membrane oxygenation. Duration of hospitalization was similar across the years of study and mortality remained low at <0.2%. Conclusion(s): The prevalence of hospitalizations for childhood asthma decreased over the 11-year period of the study; however, there was increase in hospitalizations of children with extreme illness severity and comorbid illness, with concomitant increase in the use of medical technology. This study provides new insight into the characteristics of children hospitalized with asthma over time and the associated patterns of resource use and outcomes.
Authors/Institutions: Emily A. Fretz, University of Michigan, Ann Arbor, Michigan, United States; Acham Gebremariam, University of Michigan, Ann Arbor, Michigan, United States; fola odetola, University of Michigan, Ann arbor, Michigan, United States
