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A retrospective population based trend analysis on hospital admissions for lower respiratory illness among Swedish children from 1987 to 2000.
BMC Public Health. 2003 Jul 11; 3:22.BP

Abstract

BACKGROUND

Data relating to hospital admissions of very young children for wheezing illness have been conflicting. Our primary aim was to assess whether a previous increase in hospital admissions for lower respiratory illness had continued in young Swedish children. We have included re-admissions in our analyses in order to evaluate the burden of lower respiratory illness in very young children. We have also assessed whether changes in the labelling of symptoms have affected the time trend.

METHODS

A retrospective, population based study was conducted to assess the time trend in admissions and re-admissions for lower respiratory illness. Data were obtained from the Swedish Hospital Discharge Register for all children with a first hospital admission before nine years of age, a total of 109,176 children. The register covers more than 98% of all hospital admissions in Sweden. The coding of diagnoses was based on ICD-9 from 1987 to 1996 and ICD-10 from 1997.

RESULTS

The first admission rates declined significantly in children with a first admission after two years of age. However, an increasing admission trend was observed in children aged less than one year and 35% of first admissions occurred in this age group. The annual increase was 3.8% (95% CI 1.3-6.3) in boys and 5.0% (95% CI 2.4-7.6) in girls. A diagnostic shift appeared to occur when ICD-10 was introduced in 1997. The asthma and pneumonia admission rate in children aged less than one year levelled off, whereas the increase in admissions for bronchitis continued. The re-admission rates for asthma decreased and the probability of re-admission was higher in boys. National drug statistics demonstrated a substantial increase in the delivery of inhaled steroids to all age groups but most prescriptions occurred to children aged one year or more.

CONCLUSION

Hospital admissions for lower respiratory illness are still increasing in children aged <1 year. Our findings are in line with other recent studies suggesting a change in the responsiveness to viral infections in very young children, but changes in admission criteria cannot be excluded. An increased use of inhaled steroids may have contributed to decreasing re-admission rates.

Authors+Show Affiliations

Mid-Sweden Epidemiological Centre, Västernorrland County Council, Sundsvall Hospital, SE-851 86 Sundsvall, Sweden. ove.bjor@lvn.seNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12857358

Citation

Björ, Ove, and Lennart Bråbäck. "A Retrospective Population Based Trend Analysis On Hospital Admissions for Lower Respiratory Illness Among Swedish Children From 1987 to 2000." BMC Public Health, vol. 3, 2003, p. 22.
Björ O, Bråbäck L. A retrospective population based trend analysis on hospital admissions for lower respiratory illness among Swedish children from 1987 to 2000. BMC Public Health. 2003;3:22.
Björ, O., & Bråbäck, L. (2003). A retrospective population based trend analysis on hospital admissions for lower respiratory illness among Swedish children from 1987 to 2000. BMC Public Health, 3, 22.
Björ O, Bråbäck L. A Retrospective Population Based Trend Analysis On Hospital Admissions for Lower Respiratory Illness Among Swedish Children From 1987 to 2000. BMC Public Health. 2003 Jul 11;3:22. PubMed PMID: 12857358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A retrospective population based trend analysis on hospital admissions for lower respiratory illness among Swedish children from 1987 to 2000. AU - Björ,Ove, AU - Bråbäck,Lennart, Y1 - 2003/07/11/ PY - 2003/03/27/received PY - 2003/07/11/accepted PY - 2003/7/15/pubmed PY - 2004/5/25/medline PY - 2003/7/15/entrez SP - 22 EP - 22 JF - BMC public health JO - BMC Public Health VL - 3 N2 - BACKGROUND: Data relating to hospital admissions of very young children for wheezing illness have been conflicting. Our primary aim was to assess whether a previous increase in hospital admissions for lower respiratory illness had continued in young Swedish children. We have included re-admissions in our analyses in order to evaluate the burden of lower respiratory illness in very young children. We have also assessed whether changes in the labelling of symptoms have affected the time trend. METHODS: A retrospective, population based study was conducted to assess the time trend in admissions and re-admissions for lower respiratory illness. Data were obtained from the Swedish Hospital Discharge Register for all children with a first hospital admission before nine years of age, a total of 109,176 children. The register covers more than 98% of all hospital admissions in Sweden. The coding of diagnoses was based on ICD-9 from 1987 to 1996 and ICD-10 from 1997. RESULTS: The first admission rates declined significantly in children with a first admission after two years of age. However, an increasing admission trend was observed in children aged less than one year and 35% of first admissions occurred in this age group. The annual increase was 3.8% (95% CI 1.3-6.3) in boys and 5.0% (95% CI 2.4-7.6) in girls. A diagnostic shift appeared to occur when ICD-10 was introduced in 1997. The asthma and pneumonia admission rate in children aged less than one year levelled off, whereas the increase in admissions for bronchitis continued. The re-admission rates for asthma decreased and the probability of re-admission was higher in boys. National drug statistics demonstrated a substantial increase in the delivery of inhaled steroids to all age groups but most prescriptions occurred to children aged one year or more. CONCLUSION: Hospital admissions for lower respiratory illness are still increasing in children aged <1 year. Our findings are in line with other recent studies suggesting a change in the responsiveness to viral infections in very young children, but changes in admission criteria cannot be excluded. An increased use of inhaled steroids may have contributed to decreasing re-admission rates. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/12857358/A_retrospective_population_based_trend_analysis_on_hospital_admissions_for_lower_respiratory_illness_among_Swedish_children_from_1987_to_2000_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-3-22 DB - PRIME DP - Unbound Medicine ER -