Acute Asthma in the Pediatric Emergency Department: Infections Are the Main Triggers of Exacerbations

Biomed Res Int. 2017:2017:9687061. doi: 10.1155/2017/9687061. Epub 2017 Oct 12.

Abstract

Background: Asthma exacerbations are a common reason for Emergency Department (ED) visits in children.

Aim: To analyze differences among age groups in terms of triggering factors and seasonality and to identify those with higher risk of severe exacerbations.

Methods: We retrospectively revised the files of children admitted for acute asthma in 2016 in our Pediatric ED.

Results: Visits for acute asthma were 603/23197 (2.6%). 76% of the patients were <6 years old and 24% ≥6. Infections were the main trigger of exacerbations in both groups; 33% of the school-aged children had a triggering allergic condition (versus 3% in <6 years; p < .01). 191 patients had a previous history of asthma; among them, 95 were ≥6 years, 67% of whom were not using any controller medication, showing a higher risk of a moderate-to-severe exacerbation than those under long-term therapy (p < .01). Exacerbations peaked in autumn and winter in preschoolers and in spring and early autumn in the school-aged children.

Conclusions: Infections are the main trigger of acute asthma in children of any age, followed by allergy in the school-aged children. Efforts for an improved management of patients affected by chronic asthma might go through individualized action plans and possibly vaccinations and allergen-avoidance measures.

MeSH terms

  • Acute Disease / epidemiology
  • Adolescent
  • Allergens*
  • Asthma / epidemiology
  • Asthma / etiology
  • Asthma / pathology
  • Asthma / therapy*
  • Child
  • Child, Preschool
  • Emergency Service, Hospital
  • Female
  • Hospitalization
  • Humans
  • Hypersensitivity / epidemiology
  • Hypersensitivity / etiology
  • Hypersensitivity / pathology
  • Hypersensitivity / therapy*
  • Infant
  • Infant, Newborn
  • Infections / complications
  • Infections / epidemiology
  • Infections / physiopathology
  • Infections / therapy*
  • Male
  • Seasons

Substances

  • Allergens