Risk of Rehospitalization and Death in Patients Hospitalized Due to Asthma
Ekström, Magnus LU
; Nwaru, Bright I.
; Wiklund, Fredrik
; Telg, Gunilla
and Janson, Christer
(2021)
In Journal of Allergy and Clinical Immunology: In Practice
9(5).
p.4-1968
- Abstract
Background: Asthma is a heterogeneous inflammatory airway disease that continues to cause considerable morbidity across the world, with poor asthma control leading to hospitalizations. Objective: The present study investigated the risk of rehospitalization, mortality, and the management of patients with asthma who had been hospitalized because of an asthma exacerbation. Methods: National Swedish health registries were linked for patients 6 years or older who were admitted to hospital because of asthma (index date) between January 1, 2006, and December 31, 2015. Exacerbations were defined as asthma-related hospitalization, emergency visits, or collection of oral steroids. Patients were followed for rehospitalizations 12 months after the... (More)
Background: Asthma is a heterogeneous inflammatory airway disease that continues to cause considerable morbidity across the world, with poor asthma control leading to hospitalizations. Objective: The present study investigated the risk of rehospitalization, mortality, and the management of patients with asthma who had been hospitalized because of an asthma exacerbation. Methods: National Swedish health registries were linked for patients 6 years or older who were admitted to hospital because of asthma (index date) between January 1, 2006, and December 31, 2015. Exacerbations were defined as asthma-related hospitalization, emergency visits, or collection of oral steroids. Patients were followed for rehospitalizations 12 months after the index date, health care resource utilization and treatment for 36 months, and mortality to study end. Regression models for time-to-event analyses were applied to assess risk factors for rehospitalization and mortality. Results: A total of 15,691 patients (mean age, 51.5 years; 63% females) were included, of whom 1,892 (12%) were rehospitalized for asthma within 12 months. Rehospitalized patients had a markedly increased risk of subsequent asthma-related mortality (adjusted hazard ratio, 2.80; 95% CI, 1.95-4.01) compared with those not rehospitalized. Two-third of the patients were not followed up by a hospital-based specialist, and 60% did not collect enough inhaled corticosteroid doses to cover daily treatment the year postindex. Conclusions: In this study, more than 1 in 10 patients were rehospitalized because of asthma within 12 months, and rehospitalizations were associated with asthma-related mortality. Few patients were seen by a hospital-based specialist, and few used inhaled corticosteroid continuously. Closer monitoring after hospitalization is needed.
(Less)
- author
- Ekström, Magnus
LU
; Nwaru, Bright I.
; Wiklund, Fredrik
; Telg, Gunilla
and Janson, Christer
- organization
- publishing date
- 2021-05
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Asthma, Exacerbation, Health care recourse utilization, Mortality, Pharmacological treatment, Rehospitalization
- in
- Journal of Allergy and Clinical Immunology: In Practice
- volume
- 9
- issue
- 5
- pages
- 4 - 1968
- publisher
- Elsevier
- external identifiers
-
- scopus:85099620496
- pmid:33359587
- ISSN
- 2213-2198
- DOI
- 10.1016/j.jaip.2020.12.030
- language
- English
- LU publication?
- yes
- id
- cd497add-4d28-4576-a200-36383eb4e8db
- date added to LUP
- 2021-12-23 11:08:25
- date last changed
- 2024-04-20 18:15:39
@article{cd497add-4d28-4576-a200-36383eb4e8db,
abstract = {{<p>Background: Asthma is a heterogeneous inflammatory airway disease that continues to cause considerable morbidity across the world, with poor asthma control leading to hospitalizations. Objective: The present study investigated the risk of rehospitalization, mortality, and the management of patients with asthma who had been hospitalized because of an asthma exacerbation. Methods: National Swedish health registries were linked for patients 6 years or older who were admitted to hospital because of asthma (index date) between January 1, 2006, and December 31, 2015. Exacerbations were defined as asthma-related hospitalization, emergency visits, or collection of oral steroids. Patients were followed for rehospitalizations 12 months after the index date, health care resource utilization and treatment for 36 months, and mortality to study end. Regression models for time-to-event analyses were applied to assess risk factors for rehospitalization and mortality. Results: A total of 15,691 patients (mean age, 51.5 years; 63% females) were included, of whom 1,892 (12%) were rehospitalized for asthma within 12 months. Rehospitalized patients had a markedly increased risk of subsequent asthma-related mortality (adjusted hazard ratio, 2.80; 95% CI, 1.95-4.01) compared with those not rehospitalized. Two-third of the patients were not followed up by a hospital-based specialist, and 60% did not collect enough inhaled corticosteroid doses to cover daily treatment the year postindex. Conclusions: In this study, more than 1 in 10 patients were rehospitalized because of asthma within 12 months, and rehospitalizations were associated with asthma-related mortality. Few patients were seen by a hospital-based specialist, and few used inhaled corticosteroid continuously. Closer monitoring after hospitalization is needed.</p>}},
author = {{Ekström, Magnus and Nwaru, Bright I. and Wiklund, Fredrik and Telg, Gunilla and Janson, Christer}},
issn = {{2213-2198}},
keywords = {{Asthma; Exacerbation; Health care recourse utilization; Mortality; Pharmacological treatment; Rehospitalization}},
language = {{eng}},
number = {{5}},
pages = {{4--1968}},
publisher = {{Elsevier}},
series = {{Journal of Allergy and Clinical Immunology: In Practice}},
title = {{Risk of Rehospitalization and Death in Patients Hospitalized Due to Asthma}},
url = {{http://dx.doi.org/10.1016/j.jaip.2020.12.030}},
doi = {{10.1016/j.jaip.2020.12.030}},
volume = {{9}},
year = {{2021}},
}