Use of inhaled corticosteroids decreases hospital admissions for asthma in young children
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
An active use of inhaled corticosteroids for asthma has been associated with less asthma exacerbations and hospital admissions in children aged more than 2 years. The present study aimed to investigate hospital admission rates in young children from two populations in relation to the age-specific use of maintenance medication for asthma.
Annual data on children aged less than 24 months treated for asthma, including data on the use of maintenance medication based on the purchases of prescribed medications, and annual numbers of admissions to hospital and proportions of readmissions, were collected from 1995 to 1999 in two provinces of Finland. The inclusion criteria, three or more doctor-diagnosed wheezing episodes, were individually checked by the authors in each case. The mean number of children aged less than 24 months during the years of the study was 5490 in Kuopio and 9914 in Oulu area.
In the Kuopio area, during the years of the study, 16.5/1000 children aged less than 24 months were on maintenance medication for asthma, and 90% of them were receiving inhaled corticosteroids. In the Oulu area, the respective figures were 13.5/1000 (P<0.001) and 99%. The average admission rate was 7.9/1000 in the Kuopio area and 8.7/1000 in the Oulu area (P<0.05). The readmissions indicated the higher admission rates in the Oulu (40% of all admissions) than in the Kuopio (28%) area (P<0.01).
Active use of maintenance therapy by inhaled corticosteroids was associated with a decreased need of hospital treatment in young children <24 months old with asthma, mainly because of less readmissions.
- Wennergren G, Kristjánsson S, Strannegård I-L. Decrease in hospitalization for treatment of childhood asthma with increased use of antiinflammatory treatment, despite an increase in prevalence of asthma. J Allergy Clin Immunol 1996;97:742–748. CrossRef
- Morrison DS, McLoone P. Changing patterns of hospital admission for asthma, 1981–97. Thorax 2001;56:687–690. CrossRef
- Wennergren G, Strannegård IL. Asthma hospitalizations continue to decrease in schoolchildren but hospitalization rates for wheezing illnesses remain high in young children. Acta Paediatr 2002;91:1239–1245. CrossRef
- Säynäjäkangas O, Valmari P, Tuuponen T, Keistinen T. Trends in hospitalization for childhood asthma in Finland in 1996–2004. Acta Paediatr 2007;96:919–923. CrossRef
- Donahue JG, Weiss ST, Livingston JM, Goetsch MA, Greineder DK, Platt R. Inhaled corticosteroids and the risk of hospitalization for asthma. JAMA 1997;277:887–891. CrossRef
- Bisgaard H, Moller H. Changes in risk of hospital readmission among asthmatic children in Denmark, 1978–93. BMJ 1999;319:229–230.
- Minkovitz C, Andrews J, Serwint J. Rehospitalization of children with asthma. Arch Pediatr Adolesc Med 1999;153:727–730.
- Wever-Hess J, Hermans J, Kouwenberger JM, Duiverman EJ, Wever AM. Hospital admissions and readmissions for asthma in the age group 0–4 years. Pediatr Pulmonol 2001;31:30–36. CrossRef
- Korhonen K, Dunder T, Klaukka T, Reijonen TM, Issakoff K, Kiviharju M, et al. Do inhaled steroids differ from cromones in terms of hospital admission rates for asthma in children. Acta Paediatr 2004;93:1612–1618. CrossRef
- Gardner MJ, Altman DG. Confidence intervals for standardised ratios and rates. In: Gardner MJ, Altman DG, eds. Statistics with Confidence. London: BMJ, 1989: 59–60.
- Bisgaard H, Szefler S. Understanding mild persistent asthma in children: the next frontier. J Allergy Clin Immunol 2005;115:708–713. CrossRef
- Wickman M, Farahmand BY, Persson PG, Pershagen G. Hospitalization for lower respiratory disease during 20 yrs among under 5 yr children in Stockholm county: a population based survey. Eur Respir J 1998;11:366–370. CrossRef
- van Woensel JB, van Aalderen WM, Kneyber MC, Heijnen ML, Kimpen JL. Bronchiolitis hospitalizations in the Netherlands from 1991 to 1999. Arch Dis Child 2002;86:370–371. CrossRef
- Björ O, Bråbäck L. A retrospective population based trend analysis on hospital admissions for lower respiratory illness among Swedish children from 1987 to 2000. BMC Public Health 2003;3:22–31. CrossRef
- Bisgaard H, Hermansen MN, Loland L, Halkjaer LB, Buchvald F. Intermittent inhaled corticosteroids in infants with episodic wheezing. N Engl J Med 2006;354:1998–2005. CrossRef
- Bisgaard H; Study Group on Montelukast and Respiratory Syncytial Virus. A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. Am J Respir Crit Care Med 2003;167:379–383. CrossRef
- Bisgaard H, Zielen S, Garcia-Garcia ML, Johnston SL, Gilles L, Menten J, et al. Montelukast reduces asthma exacerbations in 2 to 5 years old children with intermittent asthma. Am J Respir Crit Care Med 2005;171:315–322. CrossRef
- Bacharier LB, Boner A, Carlsen KH, Eigenmann PA, Frischer T, Götz M, et al. Diagnosis and treatment of asthma in children: a PRACTALL consensus report. Allergy 2008;63:5–34. CrossRef
- Saglani S, Malmström K, Pelkonen AS, Malmberg LP, Lindahl H, Kajosaari M, et al. Airway remodeling and inflammation in symptomatic infants with reversible airflow obstruction. Am J Respir Crit Care Med 2005;171:722–727. CrossRef
- Reijonen T, Korppi M. One-year follow-up of young children hospitalized for wheezing: the influence of early anti-inflammatory therapy and risk factors for subsequent wheezing and asthma. Pediatr Pulmonol 1998;26:113–119. CrossRef
- Hofhuis W, van der Wiel EC, Nieuwhof EM, Hop WC, Affourtit MJ, Smit FJ, et al. Efficacy of fluticasone propionate on lung function and symptoms in wheezy infants. Am J Respir Crit Care Med 2005;171:328–333. CrossRef
- Guilbert TW, Morgan WJ, Zeiger RS, Mauger DT, Boehmer SJ, Szefler SJ, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med 2006;354:1985–1997. CrossRef
- Use of inhaled corticosteroids decreases hospital admissions for asthma in young children
World Journal of Pediatrics
Volume 5, Issue 3 , pp 177-181
- Cover Date
- Print ISSN
- Online ISSN
- SP Children’s Hospital, Zhejiang University School of Medicine
- Additional Links
- hospitalization rate
- inhaled corticosteroids
- population-based study
- Author Affiliations
- 1. Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
- 2. Department of Pediatrics, Oulu University Hospital, Oulu, Finland
- 3. Social Insurance Institution, Helsinki, Finland
- 4. Pediatric Research Center, Tampere University and University Hospital, Tampere, Finland
- 5. Pediatric Research Center, Tampere University and University Hospital, FIN-33014, Tampere, Finland