FEBRUARY 01, 2008

Heavy Kids with Asthma More Prone to Hospital Stays

Overweight children who present to the emergency room (ER) with an asthma attack are more likely to be admitted to the hospital than children of normal weight.

Researchers at Connecticut Children's Hospital in Hartford reported that this was the first study to examine the relationship between pediatric patients with asthma who are overweight and hospital admission during asthma exacerbations. The findings were based on a review of all children over 2 years of age seen at the hospital's ER for an asthma flare-up in 2005. Only children who had no other chronic medical conditions were included in the study. Overweight in these children was defined as being in the 95th or higher percentile of weight-for-age. The results were published in the October 2007 issue of Pediatrics.

On average, 813 children made 884 ER visits for asthma attacks during the study period; of these visits, 27% resulted in a hospital admission, including 4% to the intensive care unit. Of all the ER visits made for asthma attacks, 77% involved a child of normal weight, and 23% an overweight child.

No major differences in asthma severity or in the treatment received in the ER were noted between the overweight and normal-weight children; 34% of the overweight patients with asthma were admitted, however, compared with 25% of the normal-weight children. The researchers concluded that "overweight children with asthma have significant health-related consequences as a result of their being overweight."

Mom?s Asthma Affects Baby?s Eczema Risk

More information on the effects of maternal asthma on breast-feeding infants has come from Maastricht University in the Netherlands, where a study was conducted that found the longer a mother nurses her infant, the lower the risk of the child developing eczema. This risk increases, however, if the mother has asthma or allergies. The findings were published in the October 2007 issue of the Journal of Pediatrics.

Researchers analyzed data from the 2705 infants enrolled in the Birth Cohort Study. Questionnaires had been given to the mothers after 34 weeks of pregnancy, and at 3, 7, 12, and 24 months after birth, asking about breast-feeding, allergy manifestations, and other information. Blood samples were taken during home visits between 34 and 36 weeks of treatment.

Of all the infants studied, 2287 were breast-fed. A correlation was found between a longer duration of breast-feeding and a lower risk of eczema in infants of mothers without allergies or asthma; there was no such association for mothers with asthma, however.

Risk of Asthma Death Runs in Families

A study of genealogy records linked with death certificates in Utah suggests that the risk of dying from an asthma attack is hereditary.

Researchers at the University of Utah in Salt Lake City identified 1553 asthma-related deaths in a registry of all deaths in the state since 1904, and found that the risk of dying from asthma increased by 69% for first-degree relatives (children, full siblings) of individuals who died from asthma, compared with patients who died from asthma and had no family history of asthma deaths. This asthma death risk was higher by 34% for second-degree relatives (grandchildren, nephews, nieces, and half-siblings) and higher by 15% among third-degree relatives (greatgrandchildren, great-nieces, great-nephews, and first cousins).

The researchers concluded that the results should "provide further incentive for asthma (health care) providers to thoroughly question patients about family history, as it is a risk factor for asthma mortality." The findings were published in the November 2007 issue of American Journal of Respiratory and Critical Care Medicine.

Powder-inhalers Commonly Misused

Researchers from Klinikum Offenburg in Germany reported that 1 in 3 patients with asthma are currently using their drypowder inhalers improperly. They also found that the older the patient, and the more severe the lung disease, the less able the patient to use the inhaler correctly.

The overall error rate was 32%, but this rate varied with age; in patients younger than 60 years, the error rate was 20%, whereas the rate for patients older than 60 was 41.6%, and among those older than 80 years, the rate rose to >80%. The findings were recently presented at CHEST 2007, the 73rd scientific assembly of the American College of Chest Physicians.

The error rate also varied with disease severity. Among patients with normal lung function, the rate was 25%, but in those with severe airway obstruction, the rate was 63.6%. Error rates were considerably lower in the patient groups who had received training in the proper use of these inhalers by health care providers and higher in those who had not been trained. The researchers found that one third of patients surveyed had only been referred to the package insert for use instructions. They expressed concern that "caregivers must adopt modern teaching techniques to meet the educational requirements of their patients."

F A S T   F A C T : Individuals who live with asthma patients are 3 times more likely to also be diagnosed with the disease.