A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong
Abstract Background The real‐world relationships between the demographic and clinical characteristics of asthma patients, their prehospitalization management and the frequency of hospitalization due to asthma exacerbation is poorly established. Objective To determine the risk factors of recurrent as...
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Wiley
2021-06-01
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Series: | Immunity, Inflammation and Disease |
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Online Access: | https://doi.org/10.1002/iid3.419 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ka Pang Chan Fanny Wai San Ko Kwun Cheung Ling Pik Shan Cheung Lee Veronica Chan Yu Hong Chan Yi Tat Lo Chun Kong Ng Macy Mei‐sze Lui Kwok Sang Wilson Yee Cee Zhung Steven Tseng Pak Yiu Tse Mo Lin Maureen Wong Kah Lin Choo Wai Kei Lam Chun Man Wong Sheng Sheng Ho Chung Tat Lun Christopher Kei Wai Lai |
spellingShingle |
Ka Pang Chan Fanny Wai San Ko Kwun Cheung Ling Pik Shan Cheung Lee Veronica Chan Yu Hong Chan Yi Tat Lo Chun Kong Ng Macy Mei‐sze Lui Kwok Sang Wilson Yee Cee Zhung Steven Tseng Pak Yiu Tse Mo Lin Maureen Wong Kah Lin Choo Wai Kei Lam Chun Man Wong Sheng Sheng Ho Chung Tat Lun Christopher Kei Wai Lai A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong Immunity, Inflammation and Disease asthma (clinical aspects) asthma clinical care asthma control asthma exacerbations asthma outcomes research |
author_facet |
Ka Pang Chan Fanny Wai San Ko Kwun Cheung Ling Pik Shan Cheung Lee Veronica Chan Yu Hong Chan Yi Tat Lo Chun Kong Ng Macy Mei‐sze Lui Kwok Sang Wilson Yee Cee Zhung Steven Tseng Pak Yiu Tse Mo Lin Maureen Wong Kah Lin Choo Wai Kei Lam Chun Man Wong Sheng Sheng Ho Chung Tat Lun Christopher Kei Wai Lai |
author_sort |
Ka Pang Chan |
title |
A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong |
title_short |
A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong |
title_full |
A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong |
title_fullStr |
A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong |
title_full_unstemmed |
A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong |
title_sort |
territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in hong kong |
publisher |
Wiley |
series |
Immunity, Inflammation and Disease |
issn |
2050-4527 |
publishDate |
2021-06-01 |
description |
Abstract Background The real‐world relationships between the demographic and clinical characteristics of asthma patients, their prehospitalization management and the frequency of hospitalization due to asthma exacerbation is poorly established. Objective To determine the risk factors of recurrent asthma exacerbations requiring hospitalizations and evaluate the standard of baseline asthma care. Methods A territory‐wide, multicentre retrospective study in Hong Kong was performed. Medical records of patients aged ≥18 years admitted to 11 acute general hospitals from January 1 to December 31, 2016 for asthma exacerbations were reviewed. Results There were 2280 patients with 3154 admissions (36.7% male, median age 66.0 [interquartile range: 48.0–81.0] years, 519 had ≥2 admissions). Among them, 1830 (80.3%) had at least one asthma‐associated comorbidity, 1060 (46.5%) and 885 (38.9%) of patients had Accident and Emergency Department (AED) attendance and hospitalization in the preceding year, respectively. Patients with advancing age (incidence rate ratio [IRR]: 1.003 for every year increment), a history of AED visits or hospitalization (IRR: 1.018 and 1.070 for every additional episode, respectively) for asthma exacerbation in the preceding year, the presence of neuropsychiatric (IRR: 1.142) and gastrointestinal (IRR: 1.154) comorbidities were risk factors for an increasing number of admissions for asthma exacerbation. For patients with ≥2 admissions, 17.1% were not prescribed inhaled corticosteroid and only 44.6% had spirometry checked before the index admission. Asthma phenotyping was often incomplete, as assessment of atopy (total serum immunoglobulin E level and senitization to aeroallergens) was only performed in 30 (5.8%) patients with ≥2 admissions. Conclusions and Clinical Relevance Improving asthma care, especially in elderly patients with a prior history of urgent healthcare utilization and comorbidities, may help reduce healthcare burden. Suboptimal management before the index admission was common in patients hospitalized for asthma exacerbations. Early identification of patients at risk and enhancement of baseline asthma management may help to prevent recurrent asthma exacerbation and subsequent hospitalization. |
topic |
asthma (clinical aspects) asthma clinical care asthma control asthma exacerbations asthma outcomes research |
url |
https://doi.org/10.1002/iid3.419 |
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doaj-d09d8f84faae45eb83238d21c1887bb22021-05-17T11:29:08ZengWileyImmunity, Inflammation and Disease2050-45272021-06-019256958110.1002/iid3.419A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong KongKa Pang Chan0Fanny Wai San Ko1Kwun Cheung Ling2Pik Shan Cheung3Lee Veronica Chan4Yu Hong Chan5Yi Tat Lo6Chun Kong Ng7Macy Mei‐sze Lui8Kwok Sang Wilson Yee9Cee Zhung Steven Tseng10Pak Yiu Tse11Mo Lin Maureen Wong12Kah Lin Choo13Wai Kei Lam14Chun Man Wong15Sheng Sheng Ho16Chung Tat Lun17Christopher Kei Wai Lai18Department of Medicine & Therapeutics Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine & Therapeutics Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine & Therapeutics Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine & Geriatrics United Christian Hospital Hong Kong ChinaDepartment of Medicine & Geriatrics United Christian Hospital Hong Kong ChinaDepartment of Medicine & Geriatrics Princess Margaret Hospital Hong Kong ChinaDepartment of Medicine Pamela Youde Nethersole Eastern Hospital Hong Kong ChinaDepartment of Medicine Queen Elizabeth Hospital Hong Kong ChinaDepartment of Medicine The University of Hong Kong Hong Kong ChinaDepartment of Medicine & Geriatrics Kwong Wah Hospital Hong Kong ChinaDepartment of Medicine & Geriatrics Kwong Wah Hospital Hong Kong ChinaDepartment of Medicine Tseung Kwan O Hospital Hong Kong ChinaDepartment of Medicine & Geriatrics Caritas Medical Centre Hong Kong ChinaDepartment of Medicine North District Hospital Hong Kong ChinaDepartment of Medicine North District Hospital Hong Kong ChinaDepartment of Medicine North District Hospital Hong Kong ChinaDepartment of Medicine Alice Ho Miu Ling Nethersole Hospital Hong Kong ChinaDepartment of Medicine Alice Ho Miu Ling Nethersole Hospital Hong Kong ChinaDepartment of Medicine & Therapeutics Chinese University of Hong Kong Hong Kong ChinaAbstract Background The real‐world relationships between the demographic and clinical characteristics of asthma patients, their prehospitalization management and the frequency of hospitalization due to asthma exacerbation is poorly established. Objective To determine the risk factors of recurrent asthma exacerbations requiring hospitalizations and evaluate the standard of baseline asthma care. Methods A territory‐wide, multicentre retrospective study in Hong Kong was performed. Medical records of patients aged ≥18 years admitted to 11 acute general hospitals from January 1 to December 31, 2016 for asthma exacerbations were reviewed. Results There were 2280 patients with 3154 admissions (36.7% male, median age 66.0 [interquartile range: 48.0–81.0] years, 519 had ≥2 admissions). Among them, 1830 (80.3%) had at least one asthma‐associated comorbidity, 1060 (46.5%) and 885 (38.9%) of patients had Accident and Emergency Department (AED) attendance and hospitalization in the preceding year, respectively. Patients with advancing age (incidence rate ratio [IRR]: 1.003 for every year increment), a history of AED visits or hospitalization (IRR: 1.018 and 1.070 for every additional episode, respectively) for asthma exacerbation in the preceding year, the presence of neuropsychiatric (IRR: 1.142) and gastrointestinal (IRR: 1.154) comorbidities were risk factors for an increasing number of admissions for asthma exacerbation. For patients with ≥2 admissions, 17.1% were not prescribed inhaled corticosteroid and only 44.6% had spirometry checked before the index admission. Asthma phenotyping was often incomplete, as assessment of atopy (total serum immunoglobulin E level and senitization to aeroallergens) was only performed in 30 (5.8%) patients with ≥2 admissions. Conclusions and Clinical Relevance Improving asthma care, especially in elderly patients with a prior history of urgent healthcare utilization and comorbidities, may help reduce healthcare burden. Suboptimal management before the index admission was common in patients hospitalized for asthma exacerbations. Early identification of patients at risk and enhancement of baseline asthma management may help to prevent recurrent asthma exacerbation and subsequent hospitalization.https://doi.org/10.1002/iid3.419asthma (clinical aspects)asthma clinical careasthma controlasthma exacerbationsasthma outcomes research |