What Symptoms Predict Asthma-Related ED Visits in Adolescents?

Chest tightness and night wakening may be associated with emergency department (ED) visits and hospitalizations in urban adolescents with probable asthma, a new study found. However, there does not appear to be an association of exercise-induced wheezing with ED visits in this patient population.

For their study, the researchers evaluated 30,467 high school students attending 49 schools in New York City. Mean participant age was 16.0 years. Ultimately, the present analysis included 9149 adolescents with probable asthma.
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Participants were administered 1 brief validated measure that assessed probable asthma, as well as 1 that evaluated the frequency of 6 past-year asthma symptoms. Any past-year asthma-related ED visits and hospitalizations were also recorded. Each asthma symptom was modeled as a function of ED visits and hospitalizations via logistic regression, and results were adjusted for various factors. Multivariable models accounted for all symptoms, as well as any interactions between symptoms.

Although previous studies have suggested an association between exercise-induced wheezing and ED visits in younger children with probable asthma, findings from this study indicated otherwise in adolescents. Results of multivariable models showed that wheeze without a cold, chest tightness, and night wakening, but not exercise-induced wheezing, were significantly associated with ED visits and hospitalizations in adolescents.

“Unlike findings with younger children, [exercise-induced wheezing] does not appear to be associated with ED visits and hospitalizations among urban adolescents with probable asthma,” the researchers concluded. “Instead, symptoms, such as chest tightness and night wakening, appear to be important at identifying adolescents at risk for asthma-related urgent care.”

—Christina Vogt

Reference:

Gould CF, Perzanowski MS, Evans D, Bruzzese JM. Association of exercise-induced wheeze and other asthma symptoms with emergency department visits and hospitalizations in a large cohort of urban adolescents [Published online January 10, 2018]. Respir Med.  http://dx.doi.org/10.1016/j.rmed.2018.01.005.