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    Is secondhand smoke exposure associated with increased exacerbation severity among children hospitalized for asthma?

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    Authors
    Andrews, Annie L.
    Shirley, Nils
    Ojukwu, Elizabeth
    Robinson, Michelle
    Torok, Michelle
    Wilson, Karen M.
    Student Authors
    Elizabeth Ojukwu
    UMass Chan Affiliations
    School of Medicine
    Document Type
    Journal Article
    Publication Date
    2015-05-01
    Keywords
    Medical Education
    Pediatrics
    Respiratory Tract Diseases
    
    Metadata
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    Link to Full Text
    https://dx.doi.org/10.1542/hpeds.2014-0128
    Abstract
    OBJECTIVE: To determine the association between secondhand smoke (SHS) exposure and length of stay (LOS) and other exacerbation severity indicators in children hospitalized for asthma. METHODS: We conducted a retrospective chart review at 2 children's hospitals. Patients aged 2 to 18 hospitalized for asthma in 2012 were included. Outcome variables included LOS, PICU, magnesium, and intravenous (IV) steroids. Bivariate analysis determined differences between SHS-exposed and non-SHS-exposed groups. Geometric means were used for LOS to account for skewed distribution. Logistic and zero-truncated negative binomial regression models were used to determine the independent association between SHS exposure and hospitalization severity indicators. RESULTS: A total of 623 patients were included; 41% reported SHS exposure. Mean LOS was 47.5 hours. In the SHS-exposed group, LOS was 50.0 (95% confidence interval [CI] 46.7-54.0) and in the nonexposed group it was 45.8 (95% CI 43.4-48.4) (P = .02). In regression analysis, institution modified the effect of SHS exposure on LOS. At Children's Hospital Colorado, SHS exposure was associated with a 20% increase in LOS (incidence rate ratio 1.2, 95% CI 1.1-1.3). At the Medical University of South Carolina, there was no significant association. SHS-exposed patients were more likely to receive IV steroids (odds ratio 1.6, 95% CI 1.1-2.3). CONCLUSIONS: Among children hospitalized for asthma, we identified a significant association at 1 institution between SHS exposure and LOS and found that IV steroid use was significantly associated with LOS at both institutions. Eliminating SHS exposure among children with asthma is important.
    Source
    Hosp Pediatr. 2015 May;5(5):249-55. doi: 10.1542/hpeds.2014-0128.
    DOI
    10.1542/hpeds.2014-0128
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49106
    PubMed ID
    25934808
    Notes

    Co-author Elizabeth Ojukwu is a medical student at UMass Medical School.

    Related Resources
    Link to article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1542/hpeds.2014-0128
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