Fatores preditores de hospitalização por asma em crianças e adolescentes participantes de um programa de controle da asma

Abstract

Objective: To determine the clinical characteristics and the predictors of hospital admission due to asthma among children and adolescents with asthma under treatment at a referral center. Methods: A retrospective cohort study comprising 151 children and adolescents with asthma, referred from the Unified Health Care System and enrolled in the Asthma and Allergic Rhinitis Control Program in the city of Feira de Santana, Brazil, followed for a period of 12 months and receiving asthma medication at no cost. The chi-square test was used in order to determine the associations between the studied variables and the occurrence of hospital admissions, whereas the Mann-Whitney test was used for the comparison between the groups of hospitalized patients and nonhospitalized patients. The level of significance was set at p < 0.05. Univariate analysis with logistic regression was performed in order to determine the predictors of hospital admission. Results: Of the 151 patients evaluated, 8 (5.2%) were hospitalized, in a total of 12 hospital admissions. In the univariate analysis, the only variable found to be a predictive factor was greater asthma severity (OR = 13.3; 95% CI: 2.55-70.1). Conclusions: The fact that, in our study sample, the principal predictor of hospital admission was greater asthma severity, calls for special attention being given to the care of these patients.

A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press

“…The low prevalence of physician-diagnosed asthma suggests that asthma continues to be under-diagnosed. Brandao et al68 examined the clinical characteristics and the predictors of hospital admission due to asthma among children and adolescents with asthma under treatment at a referral center. and found that the principal predictor of hospital admission was greater asthma severity, calls for special attention being given to the care of these patients.…”

Prevalence of Asthma symptoms and risk factors in adolescents

“…The importance of wheezing was evident from the association we found between the presence of wheezing and hospitalization in girls of public schools. In children, risk factors associated with hospitalization are related to inadequate treatment, lack of follow-up during treatment, frequent exacerbations, age < 5 years and low socioeconomic status 13 .…”

Compreensão da família acerca da asma infantil em uma unidade de urgência e emergência pediátrica

“…Apesar de reconhecerem os sintomas que caracterizam a crise da asma na criança, os familiares apresentaram pouco artigo original entendimento acerca da doença. Este fato pode ser justificado pela ausência de um acompanhamento contínuo voltado para o controle da asma (8) , já que todos os participantes do presente estudo não o realizavam.…”

“…Ficou evidente uma maior necessidade de cuidado por parte dos profissionais de saúde, visto que as famílias apresentaram dificuldades no acompanhamento do tratamento da criança asmática e esse se configura como pertinente no processo de obtenção do controle da doença. A qualidade do tratamento decorre (8), do uso adequado das medicações com a garantia da realização da técnica inalatória correta, assim como a orientação sobre um plano de ação para o controle dos sintomas. Tais medidas aparecem como adequadas para mudar o cenário das hospitalizações por asma .…”