No breastfeeding, maternal age at child's birth of less than 30 years, routine use of acetaminophen for fever in the child in the 12 months previous to the survey application, older siblings at birth, and primary or secondary school as the highest level of education attained by mother were independent predictors of severe asthma. Some of these risk factors are clearly modifiable. Further prospective, population-based studies with a bigger sample size and a more representative sample of the general population residing in the city are needed to retest and clarify these associations.
BackgroundBronchiolitis is the leading cause of hospitalization in children. Estimate potentially preventable variables that impact the length of hospital stay are a priority to reduce the costs associated with this disease.ObjectiveThis study aims to identify clinical variables associated with length of hospital stay of bronchiolitis in children in a tropical middle-income countryMethodsWe conducted a retrospective cohort study in 417 infants with bronchiolitis in tertiary centers in Colombia. All medical records of all patients admitted to the emergency department were reviewed. To identify factors independently associated we use negative binomial regression model, to estimate incidence rate ratios (IRR) and adjust for potential confounding variablesResultsThe median of the length of hospital stay was 3.68 days, with a range of 0.74 days to 29 days, 138 (33.17%) of patients have a hospital stay of 5 or more days. After modeling and controlling for potential confounders age < 6 months, comorbidities (CHD or neurological), BPD, chest indrawing, RSV isolation, and C-reactive protein were independent predictors of LOSConclusionsOur results show that in infants with bronchiolitis, RSV isolation, age < 6 months, comorbidities (CHD or neurological), BPD, chest indrawing, and C-reactive protein were independent predictors of LOS. As a potentially modifiable risk factor, efforts to reduce the probability of RSV infection can reduce the hight medical cost associates with prolonged LOS in bronchiolitis.
INTRODUCCIÓN Aunque existen instrumentos para medir el nivel de sobrecarga en los padres/cuidadores de niños con enfermedades crónicas, pocos estudios los han validado para utilizarlos en el contexto del asma pediátrica.METODOLOGÍA Se efectuó un estudio analítico de corte transversal y de validación de escala. Se evaluó el grado de sobrecarga de los padres/cuidadores de niños asmáticos utilizando la Escala de Zarit (EZ). Se hizo un análisis factorial confirmatorio para verificar la estructura factorial de la EZ y se evaluaron su validez de constructo y su consistencia interna. Se ajustaron modelos de regresión logística para identificar factores asociados con un nivel de sobrecarga intensa en los padres y/o cuidadores de los niños asmáticos.RESULTADOS Del total de padres y/o cuidadores, se consideró que 26 (10,0%) estaban experimentando sobrecarga intensa. La estructura factorial descrita para la EZ se ajusta aceptablemente cuando se utiliza para medir el nivel de sobrecarga que experimentan los padres/cuidadores de niños asmáticos (X2 = 59,47; gl =19; p < 0,001; CFI = 0,93; TLI = 0,90; RMSEA = 0,09). Además, la edad del cuidador (OR: 1,07; IC 95%: 1,00-1,15; p = 0,04), la unión libre como estado civil de los padres/ cuidadores (OR: 3,96; IC 95%: 1,27-12,35; p = 0,02) y la madre como el tipo de cuidador (OR: 8,87; IC 95%: 1,13-69,61; p =0,04) se identificaron como predictores independientes de sobrecarga intensa.CONCLUSIONES La EZ es un instrumento adecuado para determinar el nivel de sobrecarga que experimentan los padres y/o cuidadores de niños asmáticos. La edad del cuidador, la unión libre y la madre como el tipo de cuidador son predictores independientes de un nivel de sobrecarga intensa.
Objectives. Although recent evidence suggests that management of viral bronchiolitis requires something other than guidelinesguided therapy, there is a lack of evidence supporting the economic benefits of phenotypic-guided bronchodilator therapy for treating this disease. The aim of the present study was to compare the cost-effectiveness of phenotypic-guided versus guidelinesguided bronchodilator therapy in infants with viral bronchiolitis. Methods: A decision-analysis model was developed in order to compare the cost-effectiveness of phenotypic-guided versus guidelines-guided bronchodilator therapy in infants with viral
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