Age- and gender-specific trends in respiratory outpatient visits and diagnoses 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 trends of respiratory diseases over long period of time is limited. This study aimed to determine the trends of respiratory disease outpatient visits (ROVs) and diagnoses (RODs) in one of the largest children's teaching hospitals in China between 2009 and 2018. Methods: A retrospective study based on routine administrative data was designed and implemented according to the RECORD statement. Demographic details and diagnoses of the outpatients < 18 years visiting the respiratory department of the hospital were extracted from the Hospital Information System. Age-and gender-specific trends were illustrated by calculating average annual growth rate (AAGR) for ROVs and comparing change of proportion for different RODs over time. Results: There were 698,054 ROVs from 285,574 children (40.4% female). AAGR of ROVs was 15.2%. Children aged 4 to < 7 years had a faster increase than other age groups. Bronchitis (27.6%), pneumonia (18.5%), pneumonia affecting other systems (18.4%), asthma and status asthmaticus (10.7%), and vasomotor and allergic rhinitis (9.2%) accounted for 84.4% of all RODs. The proportion of bronchitis decreased across years, with the concomitant increasing trend in the proportion of pneumonia. Age-specific trend in diagnoses showed greater proportion of asthma in all visits for the children aged 7 to < 18 years than younger children. Gender-specific trend in diagnoses showed the proportion of asthma was greater for males but the AAGR was greater for females. Conclusion: The persistent upward trend in ROVs was observed among children at different ages and a gender difference was also seen. In contrast to what has been reported, burden of asthma and allergies diseases continues to increase locally.

Asthma and Other Respiratory Diseases of Children in Relation to Personal Behavior, Household, Parental and Environmental Factors in West China

“…Children have a higher susceptibility to the adverse health effects of external factors due to their immature immune systems, their underdeveloped lung and metabolic systems, as well as high ventilation rates and mouth breathing, leading to an increased risk of impaired lung function and respiratory diseases [ 5 ]. A 10-year retrospective study started in 2009 based on one of the largest children’s teaching hospitals in China reported that bronchitis with a prevalence of 27.6%, pneumonia (18.5%), pneumonia affecting other systems (18.4%), and asthma and status asthmaticus (10.7%) were the top four most prevalent respiratory diseases and accounted for 75.2% of all recorded respiratory disease diagnoses [ 6 ]. It is reported that the prevalence of asthma in children increased from 0.91% in 1990 to 2.12% in 2010 [ 7 ].…”

A classification framework for identifying bronchitis and pneumonia in children based on a small-scale cough sounds dataset

“…Each year, childhood respiratory infections significantly burden our healthcare system regarding staffing and resource utilization [ 1 , 2 ]. Statistics from one of the largest children’s hospitals in China showed that bronchitis and pneumonia are the leading respiratory diseases in outpatient during the decade [ 3 ], of which pneumonia has been the leading cause of death under 5 years old worldwide for the past three decades. It is estimated that 1.2 million children under the age of five die of pneumonia yearly [ 4 ].…”

Characteristics of childhood allergic diseases in outpatient and emergency departments in Shanghai, China, 2016–2018: a multicenter, retrospective study

“…Huang et al [5] reported a prevalence of 10.2% for asthma, 54.1% for rhinitis, and 22.5% for eczema in Shanghai, China. A retrospective study conducted in a tertiary pediatric hospital in Shanghai reported that asthma and rhinitis accounted for 20% of respiratory outpatient visits [6]. ADs are often associated with various comorbidities, which have a significant impact on health outcomes [7][8][9][10].…”