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Hospitalizations for asthma in an urban population: 1995-1999.
Ann Allergy Asthma Immunol. 2009 Aug; 103(2):128-33.AA

Abstract

BACKGROUND

Asthma hospitalizations occur commonly. Many are preventable if asthma is well controlled. Medications and demographic factors affect asthma hospitalization rates. Recent studies suggest that inhaled long-acting beta-agonists (LABAs) may heighten risk of serious asthma exacerbation, particularly in African Americans.

OBJECTIVES

To further our understanding of the greater asthma morbidity associated with African American race and to investigate possible risk associated with LABAs.

METHODS

In an ecologic analysis, asthma hospitalization rates in individuals aged 5 to 64 years were determined for Philadelphia zip codes in period 1 (1995-1997) and period 2 (1997-1999) and were studied for associations with asthma drug prescription rates, demographic factors, and numbers and types of asthma care providers.

RESULTS

Higher hospitalization rates were found in African Americans vs Caucasians (45.7 vs 7.6 per 10,000) and in 5- to 17-year-olds vs 18- to 34- and 35- to 64-year-olds (30.4 vs 11.9 and 13.7 per 10,000). Hospitalizations were correlated directly with prescriptions for inhaled short-acting beta-agonists (SABAs) in periods 1 (r(s) = 0.61) and 2 (r(s) = 0.60) and inversely with LABA prescriptions in periods 1 (r(s) = -0.56) and 2 (r(s) = -0.66). Higher SABA prescription rates were also correlated with greater proportions of African Americans per zip code in periods 1 (r(s) = 0.58) and 2 (r(s) = 0.53). At all poverty levels, African Americans had higher hospitalization rates than Caucasians. Asthma hospitalization was significantly associated with poverty area residence (relative risk [RR], 2.29) and with African American race (RR, 4.31) and age (RR, 1.15) as individual-level variables (P < .001, Poisson regression).

CONCLUSIONS

These data do not support the contention that LABA exposure is a major cause of asthma morbidity. Risk of asthma hospitalization is strongly associated with being African American.

Authors+Show Affiliations

Respiratory Institute, Section of Allergy and Immunology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. langd@ccf.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19739425

Citation

Lang, David M., et al. "Hospitalizations for Asthma in an Urban Population: 1995-1999." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 103, no. 2, 2009, pp. 128-33.
Lang DM, Polansky M, Sherman MS. Hospitalizations for asthma in an urban population: 1995-1999. Ann Allergy Asthma Immunol. 2009;103(2):128-33.
Lang, D. M., Polansky, M., & Sherman, M. S. (2009). Hospitalizations for asthma in an urban population: 1995-1999. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 103(2), 128-33. https://doi.org/10.1016/S1081-1206(10)60165-2
Lang DM, Polansky M, Sherman MS. Hospitalizations for Asthma in an Urban Population: 1995-1999. Ann Allergy Asthma Immunol. 2009;103(2):128-33. PubMed PMID: 19739425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospitalizations for asthma in an urban population: 1995-1999. AU - Lang,David M, AU - Polansky,Marcia, AU - Sherman,Michael S, PY - 2009/9/11/entrez PY - 2009/9/11/pubmed PY - 2009/10/3/medline SP - 128 EP - 33 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 103 IS - 2 N2 - BACKGROUND: Asthma hospitalizations occur commonly. Many are preventable if asthma is well controlled. Medications and demographic factors affect asthma hospitalization rates. Recent studies suggest that inhaled long-acting beta-agonists (LABAs) may heighten risk of serious asthma exacerbation, particularly in African Americans. OBJECTIVES: To further our understanding of the greater asthma morbidity associated with African American race and to investigate possible risk associated with LABAs. METHODS: In an ecologic analysis, asthma hospitalization rates in individuals aged 5 to 64 years were determined for Philadelphia zip codes in period 1 (1995-1997) and period 2 (1997-1999) and were studied for associations with asthma drug prescription rates, demographic factors, and numbers and types of asthma care providers. RESULTS: Higher hospitalization rates were found in African Americans vs Caucasians (45.7 vs 7.6 per 10,000) and in 5- to 17-year-olds vs 18- to 34- and 35- to 64-year-olds (30.4 vs 11.9 and 13.7 per 10,000). Hospitalizations were correlated directly with prescriptions for inhaled short-acting beta-agonists (SABAs) in periods 1 (r(s) = 0.61) and 2 (r(s) = 0.60) and inversely with LABA prescriptions in periods 1 (r(s) = -0.56) and 2 (r(s) = -0.66). Higher SABA prescription rates were also correlated with greater proportions of African Americans per zip code in periods 1 (r(s) = 0.58) and 2 (r(s) = 0.53). At all poverty levels, African Americans had higher hospitalization rates than Caucasians. Asthma hospitalization was significantly associated with poverty area residence (relative risk [RR], 2.29) and with African American race (RR, 4.31) and age (RR, 1.15) as individual-level variables (P < .001, Poisson regression). CONCLUSIONS: These data do not support the contention that LABA exposure is a major cause of asthma morbidity. Risk of asthma hospitalization is strongly associated with being African American. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/19739425/Hospitalizations_for_asthma_in_an_urban_population:_1995_1999_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(10)60165-2 DB - PRIME DP - Unbound Medicine ER -