Comparison of severity of asthma hospitalization between African American and Hispanic children in the Bronx

Diana S. Lee, Elissa B. Gross, Arda Hotz, Deepa Rastogi

Research output: Contribution to journalArticle

Abstract

Objective: There are racial and ethnic disparities in childhood asthma burden and outcomes. Although there have been comparisons between whites and minorities, there are few between minority groups. This study aimed to compare characteristics of asthma hospitalizations in African American and Hispanic children. Methods: A retrospective chart review was conducted to compare asthma characteristics between African American and Hispanic children aged 2–18 years hospitalized at an urban, tertiary care hospital for an acute asthma exacerbation. Length of stay (LOS), need for intensive care unit (ICU), and need for additional medications or respiratory support were compared between the groups. Results: Of the 925 children that met the inclusion criteria, 64% were Hispanic and 36% were African American. The groups were similar in age, gender, insurance status, and weight classification. African American children were more likely to have severe persistent asthma (12% vs. 7%, p =.02). They were also more likely to require magnesium sulfate (45% vs. 32%, p <.001) and admission to the ICU from the emergency department (ED) (14% vs. 8%, p =.01), which were independent of asthma severity. There was no significant difference in LOS or other characteristics of hospitalization. Conclusions: African American children hospitalized for asthma have more severe exacerbations compared to Hispanic children, which is independent of their asthma severity. However, this was not associated with longer LOS, which may indicate greater responsiveness to inpatient asthma management. Further investigation is needed to understand the mechanisms underlying asthma and exacerbation severity among minority groups.

Original languageEnglish (US)
JournalJournal of Asthma
DOIs
StatePublished - Jan 1 2019

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Hispanic Americans
African Americans
Hospitalization
Asthma
Length of Stay
Minority Groups
Intensive Care Units
Magnesium Sulfate
Hospitalized Child
Insurance Coverage
Tertiary Healthcare
Tertiary Care Centers
Hospital Emergency Service
Inpatients
Weights and Measures

Keywords

  • disparity
  • exacerbation
  • Inpatient
  • minority groups
  • urban

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

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title = "Comparison of severity of asthma hospitalization between African American and Hispanic children in the Bronx",
abstract = "Objective: There are racial and ethnic disparities in childhood asthma burden and outcomes. Although there have been comparisons between whites and minorities, there are few between minority groups. This study aimed to compare characteristics of asthma hospitalizations in African American and Hispanic children. Methods: A retrospective chart review was conducted to compare asthma characteristics between African American and Hispanic children aged 2–18 years hospitalized at an urban, tertiary care hospital for an acute asthma exacerbation. Length of stay (LOS), need for intensive care unit (ICU), and need for additional medications or respiratory support were compared between the groups. Results: Of the 925 children that met the inclusion criteria, 64{\%} were Hispanic and 36{\%} were African American. The groups were similar in age, gender, insurance status, and weight classification. African American children were more likely to have severe persistent asthma (12{\%} vs. 7{\%}, p =.02). They were also more likely to require magnesium sulfate (45{\%} vs. 32{\%}, p <.001) and admission to the ICU from the emergency department (ED) (14{\%} vs. 8{\%}, p =.01), which were independent of asthma severity. There was no significant difference in LOS or other characteristics of hospitalization. Conclusions: African American children hospitalized for asthma have more severe exacerbations compared to Hispanic children, which is independent of their asthma severity. However, this was not associated with longer LOS, which may indicate greater responsiveness to inpatient asthma management. Further investigation is needed to understand the mechanisms underlying asthma and exacerbation severity among minority groups.",
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AU - Gross, Elissa B.

AU - Hotz, Arda

AU - Rastogi, Deepa

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N2 - Objective: There are racial and ethnic disparities in childhood asthma burden and outcomes. Although there have been comparisons between whites and minorities, there are few between minority groups. This study aimed to compare characteristics of asthma hospitalizations in African American and Hispanic children. Methods: A retrospective chart review was conducted to compare asthma characteristics between African American and Hispanic children aged 2–18 years hospitalized at an urban, tertiary care hospital for an acute asthma exacerbation. Length of stay (LOS), need for intensive care unit (ICU), and need for additional medications or respiratory support were compared between the groups. Results: Of the 925 children that met the inclusion criteria, 64% were Hispanic and 36% were African American. The groups were similar in age, gender, insurance status, and weight classification. African American children were more likely to have severe persistent asthma (12% vs. 7%, p =.02). They were also more likely to require magnesium sulfate (45% vs. 32%, p <.001) and admission to the ICU from the emergency department (ED) (14% vs. 8%, p =.01), which were independent of asthma severity. There was no significant difference in LOS or other characteristics of hospitalization. Conclusions: African American children hospitalized for asthma have more severe exacerbations compared to Hispanic children, which is independent of their asthma severity. However, this was not associated with longer LOS, which may indicate greater responsiveness to inpatient asthma management. Further investigation is needed to understand the mechanisms underlying asthma and exacerbation severity among minority groups.

AB - Objective: There are racial and ethnic disparities in childhood asthma burden and outcomes. Although there have been comparisons between whites and minorities, there are few between minority groups. This study aimed to compare characteristics of asthma hospitalizations in African American and Hispanic children. Methods: A retrospective chart review was conducted to compare asthma characteristics between African American and Hispanic children aged 2–18 years hospitalized at an urban, tertiary care hospital for an acute asthma exacerbation. Length of stay (LOS), need for intensive care unit (ICU), and need for additional medications or respiratory support were compared between the groups. Results: Of the 925 children that met the inclusion criteria, 64% were Hispanic and 36% were African American. The groups were similar in age, gender, insurance status, and weight classification. African American children were more likely to have severe persistent asthma (12% vs. 7%, p =.02). They were also more likely to require magnesium sulfate (45% vs. 32%, p <.001) and admission to the ICU from the emergency department (ED) (14% vs. 8%, p =.01), which were independent of asthma severity. There was no significant difference in LOS or other characteristics of hospitalization. Conclusions: African American children hospitalized for asthma have more severe exacerbations compared to Hispanic children, which is independent of their asthma severity. However, this was not associated with longer LOS, which may indicate greater responsiveness to inpatient asthma management. Further investigation is needed to understand the mechanisms underlying asthma and exacerbation severity among minority groups.

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