Factors Related With the Higher Percentage of Hospitalizations Due to Asthma Amongst Women: The FRIAM Study

Stigma and self-esteem in patients of bronchial asthma

Asthma is a debilitating chronic disease that renders individuals physically as well as mentally sick. The perception of stigmatization further leads to inappropriate control of asthma resulting in a bidirectional relationship. A prospective, cross-sectional study was conducted in a tertiary care centre of semi urban area of north India during 2021-2022. Three hundred cases of bronchial asthma and 50 healthy controls were enrolled. The asthma control test (ACT) was used to evaluate the control of asthma. Stigma and self-esteem were measured with the use of 28 item self-stigma scale, Rosenberg self-esteem scale, and stigma-related social problem scale (SPSS). The impact of sociodemographic and clinical profiles on stigma and self-esteem was evaluated. Correlation of different scales with each other was done along with. The mean age of asthmatic patients was 47.41±15.507 years with 56% being females; 49.3% of patients were well controlled and 36.3% were partly controlled. Positive subscales of 28 item self-stigma scale, Rosenberg self-esteem scale and SSPS showed statistically significant differences between cases and controls (p<0.001). ACT significantly correlated with 28 item self-stigma scale, Rosenberg self-esteem scale and SSPS, and all three stigma and self-esteem scales correlated significantly with each other.

Factors associated with hospital admission in adult patients with asthma exacerbations: A systematic review

OBJECTIVES

A variable proportion of patients presenting to the emergency department (ED) with acute asthma require admission to hospital. Previous studies have identified select factors associated with admission following ED presentation; however, no review has synthesized the evidence in this regard. This systematic review summarizes the evidence regarding factors associated with hospital admission following ED presentation.

METHODS

Searches were conducted in seven electronic databases and common sources of grey literature. Studies reporting disposition for adults after ED presentation were included. Admission proportions and factors associated with hospitalization that remained statistically significant in multivariable analyses (p < 0.05) were reported.

RESULTS

Out of an initial 5865 identified articles, 15 articles met full inclusion criteria and 11 were included in the analyses. Female sex (n = 2) and older age (n = 2) were individual factors associated with admission. Patient vital signs and severity followed by patient attributes were the two most frequent domains associated with admission. Admission proportions were analyzed in 10 studies at an median of ∼20% with no clear change between 1996 and 2012.

CONCLUSIONS

Factors such as patient demographics (e.g., female sex, older age), patient vital signs/severity, and history are associated with admission following ED presentation for acute asthma. These can be employed by ED clinicians to effectively discern patients at high risk for admission and lead to more evidence-based decision-making.

Impact of pediatric obesity on acute asthma exacerbation in Japan

BACKGROUND

Asthma and obesity are common health problems in children. This study investigated the impact of obesity on children hospitalized with acute asthma exacerbation.

METHODS

We obtained the hospital discharge records of inpatients aged 3-8 years with a diagnosis of asthma using a national inpatient database in Japan. The patients were classified into underweight, normal weight, overweight, and obese groups using weight for height and body mass index for age provided by the World Health Organization. We compared 30-day re-admission, need for intensive care, mean total hospitalization costs, and length of hospital stay between the 4 groups using multivariable regression models.

RESULTS

Overall, 38 679 patients were identified, including 3177 underweight, 28 904 normal weight, 3334 overweight, and 3264 obese patients. The obese group showed significantly higher 30-day re-admission (adjusted odds ratio, 1.26; 95% confidence interval, 1.03-1.54) and longer length of stay (adjusted difference, 0.12 days; 95% confidence interval, 0.10-0.20 days) than the normal weight group. The threshold was a 91st percentile of weight for length or body mass index for the relationship with 30-day re-admission. No significant difference was observed between the 4 groups regarding the need for intensive care and total hospitalization costs.

CONCLUSION

These findings demonstrated that obesity was a risk factor for repeated admissions caused by asthma in children, indicating the importance for the prevention of pediatric obesity.

Age dependent sex disproportion in US asthma hospitalization rates, 2000-2010

BACKGROUND

Age-stratified sex differences in asthma hospitalizations rates have been reported to be most marked between the ages of 40 and 54 years in New York. It is not known whether age-dependent sex differences in asthma hospitalization rates also exist for the entire United States.

OBJECTIVES

To compare sex-specific hospitalization rates for asthma in adults in the United States and to describe the adjusted associations between female sex and age in the fifth to sixth decades of life.

METHODS

The National Inpatient Sample databases for 2000-2010 were queried for a principal diagnosis of asthma to calculate the ratio of female to male hospitalization rates for different decades of adult life. Logistic regression modeling was used to determine whether age in the fifth to sixth decades of life had associations with female sex that remained significant after adjusting for comorbidities and demographic features.

RESULTS

For all years of the study, there was a distinct peaking in female to male ratio most manifested in the fifth to sixth decades of life. This age grouping was significantly associated with female sex. Models revealed that female sex was significantly associated with this age grouping, even after adjustment for obesity, chronic obstructive pulmonary disease, race, insurance status, discharge year, and smoking. Excluding identifiable repeat admissions also did not abrogate the age grouping association.

CONCLUSION

There is a striking propensity of women in their fifth to sixth decades of life to be admitted for asthma, which appears to be independent of many known comorbidities.