Age- and gender-specific trends in respiratory outpatient visits and diagnosis at a tertiary pediatric hospital in China: a 10-year retrospective study

Abstract

Background: Respiratory infections are one of three leading causes of childhood mortality, and worldwide increase and recent plateau in childhood asthma has been reported. However, data on respiratory disease trends over long period of time is limited. This study aimed to determine trends in respiratory disease outpatient visits (ROVs) and diagnoses (RODs) amongst attendants to one of the largest children’s teaching hospitals in China between 2009 and 2018. Methods: A retrospective study of routine administrative data was designed and reported according to the RECORD statement. Demographic details and diagnoses of patients <18 years attended the respiratory disease clinic were extracted from the Hospital Information System. Age and gender-specific trends were analyzed by comparing change in number of clinic attendants and different diagnoses over time. Results: There were 698054 ROVs involving 285574 children (59.6% male and 40.4% female). Average growth rate of ROVs was 15.2% and children aged 4 to <7 years had a faster increase than other age groups. Lower respiratory infections (LRI) (29.6%), influenza and pneumonia (17.9%), asthma and allergic diseases (13.2%), and diseases of upper respiratory tract (12.1%) accounted for 72.8% of all RODs. Gender-specific trend in diagnoses showed the percentage of asthma and allergic diseases increased with ages, especially among the group aged between 4 to <7 years. Gender-specific trend in ROVs showed a greater increase of asthma and allergic diseases than other RODs for males and females. The percentage of asthma and other allergic diseases was greater for males but the growth rate was faster for females. Asthma and allergic diseases were evaluated as co-morbidities to LRI and associated to 25.5% of LRI patients. Conclusion: The sustainable upward trend in ROVs was observed among children at different ages and a gender differential effect was also seen. In contrast to what has been reported, asthma and allergies diseases burden continued to increase in our locally.