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Tao M, Zhang Y, Ding L, Peng D. Risk factors of sleep-disordered breathing and poor asthma control in children with asthma. BMC Pediatr 2024; 24:288. [PMID: 38689232 PMCID: PMC11059673 DOI: 10.1186/s12887-024-04762-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Sleep-disordered breathing (SDB) may lead to poor asthma control in children. OBJECTIVE To identify risk factors of SDB in children with asthma and assess its impact on asthma control. METHODS In this cross-sectional study, we collected data of outpatients with asthma at the Children's Hospital of Chongqing Medical University from June 2020 to August 2021. The Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder and the age-appropriate asthma control tests Childhood Asthma Control Test and Test for Respiratory and Asthma Control in Kids were completed. RESULTS We enrolled 397 children with a male-to-female ratio of 1.7:1 and a mean age of 5.70 ± 2.53 years. The prevalence of SDB was 21.6%. Allergic rhinitis (odds ratio OR = 3.316), chronic tonsillitis (OR = 2.246), gastroesophageal reflux (OR = 7.518), adenoid hypertrophy (OR = 3.479), recurrent respiratory infections (OR = 2.195), and a family history of snoring (OR = 2.048) were risk factors for the development of combined SDB in children with asthma (p < 0.05). Asthma was poorly controlled in 19.6% of the children. SDB (OR = 2.391) and irregular medication use (OR = 2.571) were risk factors for poor asthma control (p < 0.05). CONCLUSIONS Allergic rhinitis, chronic tonsillitis, gastroesophageal reflux, adenoid hypertrophy, recurrent respiratory infections, and a family history of snoring were independent risk factors for the development of SDB in children with asthma. SDB and irregular medication use were independent risk factors for poor asthma control.
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Affiliation(s)
- Minghui Tao
- Chongqing University FuLing Hospital, No.2 Gaosuntang Road, Fuling District, Chongqing, 408000, P.R. China
| | - Yanping Zhang
- The Children's Hospital of Chongqing Medical University, 136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, China
| | - Ling Ding
- The Children's Hospital of Chongqing Medical University, 136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, China.
| | - Donghong Peng
- The Children's Hospital of Chongqing Medical University, 136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, China.
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Scierka LE, Bradley BA, Glynn E, Davis S, Hoffman M, Tam-Williams JB, Mena-Hurtado C, Smolderen KG. Chronic Cough: Characterizing and Quantifying Burden in Adults Using a Nationwide Electronic Health Records Database. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2024; 8:50-64. [PMID: 38273985 PMCID: PMC10805682 DOI: 10.1007/s41666-023-00150-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 01/27/2024]
Abstract
Chronic cough is a common condition; until recently, no International Classification of Diseases (ICD) code for chronic cough existed; therefore, the true scope and burden of chronic cough is unclear. Using established algorithms, we examined chronic cough patients and their risk profiles, recurrent cough episodes, and subsequent 1-year health care utilization in the nationwide Cerner EHR data resource, compared with those with acute cough. An ICD-based algorithm was applied to the Cerner Health Facts EHR database to derive a phenotype of chronic cough defined as three ICD-based "cough" encounters 14-days apart over a 56-to-120-day period from 2015 to 2017. Demographics, comorbidities, and outcomes (1-year outpatient, emergency, and inpatient encounters) were collected for the chronic cough cohort and acute cough cohort. The chronic cough cohort was 61.5% female, 70.4% white, and 15.2% African American, with 13.7% being of Asian, Native American, or unknown race. Compared with the acute cough cohort, chronic cough patients were more likely to be older, female, and have chronic pulmonary disease, obesity, and depression. Predictors of recurrent chronic cough were older age and race. Those with chronic cough had more outpatient (2.48 ± 2.10 vs. 1.48 ± 0.99; SMD = 0.94), emergency (1.90 ± 2.26 vs. 1.23 ± 0.68; SMD = 0.82), and inpatient (1.11 ± 0.36 vs. 1.05 ± 0.24, SMD = 0.24) encounters compared with acute cough. While EHR-based data may provide a useful resource to identify chronic cough phenotypes, supplementary data approaches and screening methods for chronic cough can further identify the scope of the problem.
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Affiliation(s)
- Lindsey E Scierka
- Vascular Medicine Outcomes (VAMOS) Program, Department of Internal Medicine, Section of Cardiology, Yale University, New Haven, CT USA
| | - Brooklyn A Bradley
- Vascular Medicine Outcomes (VAMOS) Program, Department of Internal Medicine, Section of Cardiology, Yale University, New Haven, CT USA
- Department of Psychiatry, Yale University, 789 Howard Avenue, New Haven, CT 06519 USA
| | - Earl Glynn
- Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO USA
| | - Sierra Davis
- Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO USA
| | - Mark Hoffman
- Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO USA
| | - Jade B Tam-Williams
- Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO USA
| | - Carlos Mena-Hurtado
- Vascular Medicine Outcomes (VAMOS) Program, Department of Internal Medicine, Section of Cardiology, Yale University, New Haven, CT USA
| | - Kim G Smolderen
- Vascular Medicine Outcomes (VAMOS) Program, Department of Internal Medicine, Section of Cardiology, Yale University, New Haven, CT USA
- Department of Psychiatry, Yale University, 789 Howard Avenue, New Haven, CT 06519 USA
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Pappa A, Muschaweck M, Wenzl TG. Change of Sleep Stage during Gastroesophageal Reflux in Infants. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050836. [PMID: 37238384 DOI: 10.3390/children10050836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/15/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
INTRODUCTION This study intended to explore the existence of a temporal association of changes of sleep stage and gastroesophageal reflux (GER) in infants. MATERIALS AND METHODS Documentation of sleep stage and GER was conducted via the use of synchronized polygraphic recording combined with impedance-pH-metry in 15 infants. The total recording-time (Rt) was divided into GER-"window-time" (five seconds before and after the onset of a GER episode), "remaining GER time", and "GER-free time", and analyzed for changes of sleep stage. RESULTS a total of 462 GER episodes were identified during Rt (151.1 h) in all infants. During 1.3 h of window-time; 61 changes of sleep stage (47/h); during 5.9 h of Remaining GER-time, 139 changes of sleep stage (24/h); and during 143.9 h of GER-free time, 4087 changes of sleep stage (28/h) were documented. Change of sleep stage was strongly associated with the onset of GER (p < 0.02 and p < 0.05, respectively). CONCLUSIONS There is a strong temporal association between sleep irregularities, i.e., changes of sleep and episodes of GER in infants. When dealing with disturbed sleep in infants, GER should be considered by caregivers.
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Affiliation(s)
- Angeliki Pappa
- Klinik für Kinder-und Jugendmedizin, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Moritz Muschaweck
- Klinik für Kinder-und Jugendmedizin, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Tobias G Wenzl
- Klinik für Kinder-und Jugendmedizin, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
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Singh J, Yeoh E, Castro C, Uy C, Waters K. Polysomnography in infants with clinical suspicion of sleep-related breathing disorders. J Clin Sleep Med 2022; 18:2803-2812. [PMID: 35959947 PMCID: PMC9713917 DOI: 10.5664/jcsm.10222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES Limited data exist concerning the indications, parameters, utility of daytime polysomnography, and treatment of infants with suspected sleep-related breathing disorders. METHODS We retrospectively reviewed all polysomnography undertaken in a quaternary pediatric hospital for term infants up to 6 months of age between January 2017 and December 2019. Outcomes were evaluated, including a comparison among diagnostic groups. RESULTS Of 161 infants (58% male), 77 (48%) were ≤ 2 months old, and 103 (61%) were referred for either craniofacial abnormalities or an airway malformation. Daytime (n = 100) vs nighttime (n = 61) studies showed no differences in sleep architecture or treatment rates. Apnea-hypopnea index was > 10 events/h in 137 (85%) and was similar across different diagnostic groups, and 97 (78%) were prescribed noninvasive ventilation, with a mean treatment duration of 13.4 ± 9 months. Of the infants who were commenced on noninvasive ventilation 75% did not require it beyond 24 months. CONCLUSIONS Polysomnographic sleep parameters and the number of treatments prescribed were equivalent whether the polysomnography was performed during daytime or nighttime. Treatment with noninvasive ventilation was required in the short term for most infants with sleep-related breathing disorders, regardless of the indication for referral. CITATION Singh J, Yeoh E, Castro C, Uy C, Waters K. Polysomnography in infants with clinical suspicion of sleep-related breathing disorders. J Clin Sleep Med. 2022;18(12):2803-2812.
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Affiliation(s)
- Jagdev Singh
- Department of Respiratory Medicine and Sleep Medicine, The Children’s Hospital at Westmead, Sydney NSW, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Eugene Yeoh
- Department of Respiratory Medicine and Sleep Medicine, The Children’s Hospital at Westmead, Sydney NSW, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Chenda Castro
- Department of Respiratory Medicine and Sleep Medicine, The Children’s Hospital at Westmead, Sydney NSW, Australia
| | - Carla Uy
- Department of Respiratory Medicine and Sleep Medicine, The Children’s Hospital at Westmead, Sydney NSW, Australia
| | - Karen Waters
- Department of Respiratory Medicine and Sleep Medicine, The Children’s Hospital at Westmead, Sydney NSW, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Domino JS, Lundy P, Glynn EF, Partington M. Estimating the prevalence of neurosurgical interventions in adults with spina bifida using the Health Facts data set: implications for transition planning and the development of adult clinics. J Neurosurg Pediatr 2022; 29:371-378. [PMID: 34952525 DOI: 10.3171/2021.10.peds21293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/22/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE As the care of patients with spina bifida continues to evolve, life expectancy is increasing, leading to a critical need for transition planning from pediatric-based to adult-based care. The burden of neurosurgical care for adults with spina bifida remains unknown. In this study, the authors sought to use a large national data set to estimate the prevalence of neurosurgical interventions in adults with spina bifida. METHODS This study utilized Health Facts, which is a de-identified proprietary data set abstracted from all Cerner electronic health records. It includes 69 million unique patients with > 500 million encounters in 580 centers. Validation, technical exclusions, and data filters were applied to obtain an appropriate cohort of patients. The ICD-9 and ICD-10 codes for all types of spinal dysraphism, as well as the Current Procedural Terminology (CPT) codes for hydrocephalus procedures, spinal cord untethering, and Chiari decompression, were queried and records were retrieved. Demographic variables along with differences in age groups and temporal trends were analyzed. RESULTS Overall, 24,764 unique patients with ≥ 1 encounter with a spinal dysraphism diagnosis between 2000 and 2017 were identified. The pediatric cohort included 11,123 patients with 60,027 separate encounters, and the adult cohort included 13,641 patients with 41,618 separate encounters. The proportion of females was higher in the adult (62.9%) than in the pediatric (51.4%) cohort. Annual encounters were stable from 2 to 18 years of age, but then decreased by approximately half with a precipitous drop after age 21 years. The sex distribution of adults and children who underwent procedures was similar (54.6% female adults vs 52.4% female children). Surgical interventions in adults were common. Between 2013 and 2017, there were 4913 procedures for hydrocephalus, with 2435 (49.6%) adult patients. Similarly, 273 (33.3%) of the 819 tethered cord procedures were performed in adults, as were 307 (32.9%) of 933 Chiari decompressions. CONCLUSIONS The Health Facts database offered another option for studying care delivery and utilization in patients aging with spina bifida. The median age of this population has now reached early adulthood, and a significant number of neurosurgical procedures were performed in adults. An abrupt drop in the rate of encounters occurred at 21 years of age, possibly reflecting transition issues such as access-to-care problems and lack of coordinated care.
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Affiliation(s)
- Joseph S Domino
- 1Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Paige Lundy
- 1Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Earl F Glynn
- 2Children's Mercy Research Institute, Children's Mercy Kansas City, Kansas City; and
| | - Michael Partington
- 1Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas.,3Division of Neurosurgery, Children's Mercy Kansas City, Kansas City, Missouri
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