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Type: Journal article
Title: Retrospective review of 200 children hospitalised with acute asthma. Identification of intervention points: a single centre study
Author: Giarola, B.
McCallum, G.
Bailey, E.
Morris, P.
Maclennan, C.
Chang, A.
Citation: Journal of Paediatrics and Child Health, 2014; 50(4):286-290
Publisher: Wiley
Issue Date: 2014
ISSN: 1034-4810
Statement of
Blake F Giarola, Gabrielle B McCallum, Emily J Bailey, Peter S Morris, Carolyn Maclennan and Anne B Chang
Abstract: AIM: Indigenous Australians with asthma have higher morbidity and mortality compared with non-Indigenous Australians. In children hospitalised with acute asthma, we aimed to (i) determine if acute severity, risk factors and management differed between Indigenous and non-Indigenous children; and (ii) identify intervention points to reduce morbidity and mortality of asthma. METHODS: Retrospective review of 200 children hospitalised to Royal Darwin Hospital with asthma. We compared admission characteristics, severity indices, treatment, discharge plans and readmissions in Indigenous and non-Indigenous children. RESULTS: Median age was 3.6 years (interquartile range 2.2, 6.8). A significantly higher proportion of Indigenous children (95.2%) were exposed to tobacco smoke compared with non-Indigenous children (45.7%). The difference in proportions was -0.41 (95% confidence interval (CI) -0.60, -0.22). Other risk factors, asthma severity (moderate 83.9% vs. 83.3%; severe 16% vs. 16.1%), length of stay (1.9 vs. 1.3 days) and readmission rate (27.4% vs. 27.5%) were similar between Indigenous and non-Indigenous children. Indigenous children were significantly more likely to be followed up in a community clinic (difference in proportions = 0.10, 95% CI 0.1, 0.17) and less likely by a paediatrician. Only 62.5% of all children had an asthma action plan on discharge. CONCLUSION: Unlike other common respiratory diseases requiring hospitalisation, biological factors are unlikely major contributors to the known gap in asthma outcomes between Indigenous and non-Indigenous children. Intervention points include better identification, documentation and management of tobacco smoke exposure, delivery of salbutamol and discharge planning (including education and utilisation of asthma action plans).
Keywords: acute; asthma; child; Indigenous; respiratory
Description: Article first published online: 23 DEC 2013
Rights: © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
DOI: 10.1111/jpc.12470
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