Food allergy not associated with asthma-related ED use, hospitalization

Mahboobeh Mahdavinia

Children who experience food allergies are not at an increased risk of using emergency care from EDs or hospitalization when compared with other children with asthma, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology in Orlando

The researchers had suggested prior to the study that the increased use of these services may be connected to an increased rate of asthma within this population and is not directly related to food allergy.

“Our research, along with previous studies, has shown that children with food allergies have a significantly higher rate of ED utilization compared with kids who do not have any food allergy,” Mahboobeh Mahdavinia, MD, PhD, from the division of allergy and immunology and the department of internal medicine at Rush University Medical Center, told Infectious Diseases in Children. “This is true for kids with asthma when compared with healthy children as well.”

“Increased ED use is expected as severe disease and incidence for both of these conditions need emergency evaluation and management,” she continued. “Our current research showed that having food allergy in kids who already have asthma does not increase the rate of ED utilization compared to children who only have asthma; however, kids who have egg or milk allergy have significantly higher rates of ED visits compared to those who have tree nut allergies.”

To assess how asthma-related health care use is influenced by food allergy and type of food allergy in young children with both conditions, the researchers directed a large case control study that included children between the ages of 0 and 12 years. Every child included had an IgE-mediated food allergy and were compared with children in a control group that did not have food allergy. Recruitment occurred during well-child visits at the same general pediatrics clinic.

Asthma-related ED and hospital use was identified through a thorough chart review, and a city-wise shared electronic medical records system was used to gather data from additional EDs and hospitals within Chicago.

Of the children enrolled in the study, 492 had documented food allergies, and 64 controls without food allergy were matched based on age and gender. Asthma was more prevalent in children with food allergy, with 44% experiencing the condition compared with 14.1% of controls (P < .0001). Hospital and ED use was similar for children with asthma, whether the child had or did not have a food allergy (56.8% vs. 66.7% for ED use; 29.0% vs. 35.6% for hospitalization).

Specific food allergens — including peanut, tree nuts, egg, milk, fish and shellfish — did not make children more susceptible to increased health care use.

“We believe that counseling the parents about true indications of ED use is very important,” Mahdavinia said. “In both asthma and food allergy, children do need to go to the ED in emergency situations; however, it is very important for the parents to know when it is OK to manage the problem at home or in an outpatient clinic versus when it is time to call emergency services. Pediatricians have an important role in helping parents and children distinguish these situations and act properly.” – by Katherine Bortz

Reference:

Jois S, et al. Abstract 8. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 2-5, 2017; Orlando.

Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.