Elsevier

Respiratory Medicine

Volume 108, Issue 7, July 2014, Pages 983-991
Respiratory Medicine

National trends in hospital admissions for asthma exacerbations among pediatric and young adult population in Spain (2002–2010)

https://doi.org/10.1016/j.rmed.2014.04.008Get rights and content
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Summary

Objective

To assess the changes in incidence, use of mechanical ventilation, length of stay (LOS), costs and mortality of children (0–15 years) and young adults (16–45 years) hospitalized for asthma exacerbations.

Methods

We included patients hospitalized for asthma exacerbations in Spain from 2002 to 2010 (ICD9-CM codes 493.0x–493.9x). The data were collected from the National Hospital Discharge Database (entire population). We calculated the yearly age- and sex-specific incidence rates for each of the two groups.

Results

We included a total of 12,038 pediatric patients and 2792 young adults hospitalized for asthma exacerbations. Overall crude incidence decreased from 20.5 to 18.7 admissions per 100.000 inhabitants in the pediatric group (p < 0.05), and from 4.12 to 3.68 admissions per 100.000 inhabitants among young adults, from 2002 to 2010 (p < 0.05). By contrast, we detected a significant increase in the use of non-invasive ventilation (NIV) in both groups. The average LOS decreased during the study period, from 3.71 (SD 2.28) to 3.16 (SD 2.11) days (p < 0.05) among pediatric patients and there were not changes among young adults. During the study period, the mean cost per patient decreased from 1558.53 (SD 443.63) to 1378.41 (SD 472.71) euros in the pediatric group (p < 0.05), while increased from 2183.44 (SD 783.15) to 2564.32 (SD 1933.98) euros among young adults (p < 0.05).

Conclusion

Our results suggest a decrease in the incidence of hospital admissions for asthma exacerbations with concomitant increase in use of NIV in asthmatic patients, both pediatric and young adults patients. Although LOS and mean cost have decreased among pediatric patients, they have not changed and increased, respectively, among young adults. A better management of the disease at primary care services may explain the improvement in the incidence and outcomes.

Keywords

Asthma exacerbations
Incidence
Cost
Mortality
Outcome research
Spain

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