Sex differences among children 2–13 years of age presenting at the emergency department with acute asthma

Schatz, Michael; Clark, Sunday; Emond, Jennifer A.; Schreiber, Donald; Camargo, Carlos A.

doi:10.1002/ppul.20018

Cited by 21 publications

(12 citation statements)

References 26 publications

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“…The prevalence of the use of asthma medication and of symptoms common in asthma, including attacks of shortness of breath, recurrent wheeze and long-standing cough, was higher in women than in men. This is in agreement with the well-known shift after puberty, when asthma becomes more prevalent in women than in men (2,25).…”

Section: Discussionsupporting

confidence: 91%

Asthma in late adolescence - farm childhood is protective and the prevalence increase has levelled off

Wennergren

Ekerljung

Alm

et al. 2010

Pediatric Allergy and Immunology

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While the prevalence of and risk factors for asthma in childhood have been studied extensively, the data for late adolescence are more sparse. The aim of this study was to provide up-to-date information on the prevalence of and risk factors for asthma in the transitional period between childhood and adulthood. A secondary aim was to analyze whether the increase in asthma prevalence has levelled off. A large-scale, detailed postal questionnaire focusing on asthma and respiratory symptoms, as well as possible risk factors, was mailed to 30 000 randomly selected subjects aged 16-75 in Gothenburg and the surrounding western Sweden region. The present analyses are based on the responses from 1261 subjects aged 16-20 (560 men and 701 women). The prevalence of physician-diagnosed asthma was 9.5%, while 9.6% reported the use of asthma medicine. In the multivariate analysis, the strongest risk factors for physician-diagnosed asthma and other asthma variables were heredity for asthma and heredity for allergy, particularly if they occurred together. Growing up on a farm significantly reduced the prevalence of physician-diagnosed asthma and the likelihood of using asthma medication, OR 0.1 (95% CI 0.02-0.95). Smoking increased the risk of recurrent wheeze, long-standing cough, and sputum production. In conclusion, the prevalence of physician-diagnosed asthma and the use of asthma medication in the 16- to 20-yr age group support the notion that the increase in asthma prevalence seen between the 1950s and the 1990s has now levelled off. In line with the hygiene hypothesis, a farm childhood significantly reduced the likelihood of asthma. The adverse effects of smoking could already be seen at this young age.

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Section: Discussionsupporting

confidence: 91%

Asthma in late adolescence - farm childhood is protective and the prevalence increase has levelled off

Wennergren

Ekerljung

Alm

et al. 2010

Pediatric Allergy and Immunology

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“…Although in the current study eosinophil counts were not assessed as a risk factor, it was demonstrated that the proportion of patients experiencing ≥1 exacerbations during the follow-up period was higher in patients who had severe uncontrolled asthma (GINA Step 4/5 plus ≥2 exacerbations in the previous year) with eosinophil counts (≥300 cells/μl) than in patients who did not. The current study also demonstrated that females had a higher exacerbation risk than males, a result demonstrated in a previous study, [20] although not all studies are in agreement [21]. …”

Section: Discussionsupporting

confidence: 83%

The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA

et al. 2017

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BackgroundAsthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK.MethodsPatients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010–2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009–2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date). Outcomes included: frequency of exacerbations (asthma-related ED visit, hospitalization, or oral corticosteroid use with an asthma medical code recorded within ±2 weeks) 12 months post-index, asthma-related ED visits/hospitalization, and asthma-related costs 30 days post-index. Risk of a subsequent exacerbation was determined by proportional hazard model.ResultsOf the 222,817 and 211,807 patients with asthma included from the US and UK databases, respectively, 12.5 and 8.4% experienced ≥1 exacerbation during the follow-up period. Exacerbation frequency increased with disease severity. Among the 5,167 and 2,904 patients with an asthma-related ED visit/hospitalization in the US and UK databases, respectively, 9.2 and 4.7% had asthma-related re-admissions within 30 days. Asthma-related re-admission rates and costs increased with disease severity, approximately doubling between GINA Step 1 and 5 and in patients with ≥2 versus <2 exacerbations in the previous year. Risk of a subsequent exacerbation increased 32–35% for an exacerbation requiring ED visit/hospitalization versus oral corticosteroids.ConclusionIncreased disease severity was associated with higher exacerbation frequency, ED/hospitalization re-admission, costs and risk of subsequent exacerbation, indicating that these patients require high-intensity post-exacerbation management.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-017-0409-3) contains supplementary material, which is available to authorized users.

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“…Concurrently, among children presenting to an Emergency Department (ED), there does not seem to be any difference in admission rates for boys or girls, and no sex differences for relapse or ongoing exacerbation (40). This suggests that asthma is not inherently more severe in boys with asthma compared to girls, and that the increased rate of hospitalizations in young boys is due to differences in prevalence, not severity.…”

Section: Resultsmentioning

confidence: 96%

Impact of gender on asthma in childhood and adolescence: a GA²LEN review

Almqvist

Worm

Leynaert

2007

Allergy

492

332

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A number of studies have shown gender differences in the prevalence of wheeze and asthma. The aim of this review was to examine published results on gender differences in childhood and adolescent asthma incidence and prevalence, define current concepts and to identify new research needs. A Medline search was performed with the search words (gender OR sex) AND (child OR childhood OR adolescence) AND (asthma). Articles that reported on absence or presence of gender differences in asthma were included and reviewed, and cross-references were checked. Boys are consistently reported to have more prevalent wheeze and asthma than girls. In adolescence, the pattern changes and onset of wheeze is more prevalent in females than males. Asthma, after childhood, is more severe in females than in males, and is underdiagnosed and undertreated in female adolescents. Possible explanations for this switch around puberty in the gender susceptibility to develop asthma include hormonal changes and gender-specific differences in environmental exposures. This aspect needs consideration of the doctors and allergists who diagnose and treat asthmatic individuals. In conclusion, sex hormones are likely to play an important role in the development and outcome of the allergic immune response and asthma in particular. By obtaining functional data from appropriate models, the exact underlying mechanisms can be unravelled. To examine the effect of gender-specific differences in environmental exposures and changes of asthma prevalence and severity in puberty, larger populations may need to be investigated.

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Sex differences among children 2–13 years of age presenting at the emergency department with acute asthma

Cited by 21 publications

References 26 publications

Asthma in late adolescence - farm childhood is protective and the prevalence increase has levelled off

Asthma in late adolescence - farm childhood is protective and the prevalence increase has levelled off

The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA

Impact of gender on asthma in childhood and adolescence: a GA²LEN review

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Sex differences among children 2–13 years of age presenting at the emergency department with acute asthma

Cited by 21 publications

References 26 publications

Asthma in late adolescence - farm childhood is protective and the prevalence increase has levelled off

Asthma in late adolescence - farm childhood is protective and the prevalence increase has levelled off

The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA

Impact of gender on asthma in childhood and adolescence: a GA2LEN review

Contact Info

Product

Resources

About

Impact of gender on asthma in childhood and adolescence: a GA²LEN review