Patients with both asthma, eosinophilic esophagitis experience earlier hospital visits
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Key takeaways:
- Women with asthma outnumber men by about 3 to 1.
- Asthma encounters accounted for 4% of ED and inpatient visits.
- Multiple atopic processes may combine for a stronger inflammatory response.
HONOLULU — Patients with both eosinophilic esophagitis and asthma present to the hospital at an earlier age than those patients who only have EoE, according to an abstract presented at the CHEST Annual Meeting.
Also, asthma is more prevalent among women than among men, although the reason for this difference remains unclear, according to Linda H. Pham, DO, an internal medicine specialist with Riverside Community Hospital in Riverside, California.
“Asthma has always been an interesting topic for me because it’s so common. I feel like everyone knows someone with asthma. I was curious to see if the prevalence of asthma has changed at all over the years,” Pham told Healio.
“Furthermore, eosinophilic esophagitis is a disease that has similar pathophysiology as eosinophilic asthma so my GI colleague and I wanted to join forces to do this research project to look at both diseases and to see if we could find any particular association between them,” she continued.
The retrospective cross-section study comprised 3,678,812 adults with asthma and 5,823 with EoE seen at 185 Hospital Corporation of America hospitals between 2016 and 2021.
Over time, there was no difference in the prevalence of asthma alone and the prevalence of asthma with EoE.
However, 72.55% of the patients with asthma alone were women, representing approximately a 3:1 ratio with men (27.45%). Conversely, patients with asthma and EoE comprised comparable proportions of women and men (51.78% vs. 48.22%)
These differences may be due to differences between the genders in willingness to seek medical care or in severity of symptoms, the researchers wrote.
The study also found that men with both asthma and EoE were an average of 5.517 (95% CI, 3.938-7.095) years younger than men with EoE alone. Women with both asthma and EoE were an average of 5.48 (95% CI, 3.826-7.134) years younger than women with EoE alone.
Patients with both asthma and EoE may present to the hospital at a younger age than those patients with EoE alone because of multiple atopic processes combining for a stronger inflammatory response that requires patients to seek medical attention. These findings suggest but do not confirm a relationship between asthma and EoE, the researchers noted.
“The most significant finding would be that patients who have both eosinophilic esophagitis and asthma presented earlier in age to the hospital than patients with just one of these diseases,” Pham told Healio.
“This is significant because it does not confirm a direct association or relationship between the two diseases, but it does show that they have an additive effect on age of hospital presentation,” she said.
Patients with asthma also represented 4% of all ED and inpatient encounters, which the researchers called a relatively small percentage, and 18.16% of patients with asthma who presented to the ED were admitted to the hospital.
The researchers called for additional investigation into whether patients with other atopic conditions in association with asthma also experience hospital admissions at an earlier age than patients with these conditions alone.
“I would like to compare asthma to other atopic conditions such as atopic dermatitis and similarly see if there are any associations or relationships that can be made,” Pham said. “In particular, I would be interested in seeing if patients with both asthma and atopic dermatitis also present earlier in age to the hospital than those with just one.”
In the meanwhile, Pham said, doctors may consider that patients with one atopic condition such as asthma may have another such as EoE.
“If patients do have multiple atopic conditions, doctors can be cognizant of the possibility that the patient may be more susceptible to an exacerbation that may lead their patients to seek emergency treatment,” Pham said.
“If doctors can make patients aware of this possibility, patients can pay better attention to their symptoms and seek appropriate help if needed,” she said.
For more information:
Linda H. Pham, DO, can be reached at lindapham310@gmail.com.