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Obesity linked to repeated hospital admissions in children with asthma

Yusuke Okubo

Obesity was a risk factor for repeated hospital admissions in children with asthma, according to findings recently published in Pediatric Allergy and Immunology.

“Even though several studies have proved the burden of pediatric obesity on acute asthma exacerbations, and weight control seems to be one of the important factors to prevent these exacerbations, some children with obesity and their parents still do not understand the benefits of weight reduction,” Yusuke Okubo, MD, MPH, of the department of social medicine, National Research Institute for Child Health and Development in Tokyo, told Healio Family Medicine. “We conducted this research to emphasize the importance of preventing obesity, especially for these children and their parents.”

Okubo and colleagues used information within the Diagnosis Procedure Combination inpatient database collected between July 1, 2010, and March 31, 2015, for their research. They also gathered data on preexisting comorbidities of allergic disorders such as food allergy; atopic dermatitis or eczema; or allergic rhinitis in 38,679 Japanese patients aged 3 to 18 years and diagnosed with asthma. Based on BMI, patients were classified as underweight (n = 3,177), normal weight (n = 28,904), overweight (n = 3,334) or obese (n = 3,264).

Outcomes were 30-day readmission, need for intensive care (defined as ICU admission or either the use of extra corporeal membrane oxygenation; noninvasive and/or invasive mechanical ventilation), length of hospital stay, and mean total hospitalization costs in Japanese yen.

Researchers found that patients with obesity had a statistically significantly higher 30-day re-admission rate (adjusted OR = 1.26; 95% CI, 1.03-1.54) and longer length of stay (adjusted difference, 0.12 days; 95% CI, 0.1-0.2) than the normal weight group. The threshold for the relationship between length of stay for the association with a 30-day readmission was weight in the 91st percentile.

The adjusted ORs for 30-day readmission and length of stay for the underweight and overweight groups vs. the normal weight group was insignificant. There was no significant difference between the four patient groups regarding total hospitalization costs and need for intensive care.

Okubo provided suggestions for PCPs who may find it difficult to broach the study’s findings with patients and their parents.

“Clinicians can explain that besides asthma control, controlling obesity has many other health benefits, such as the prevention of diabetes, high blood pressure, or dyslipidemia,” he said in the interview.

He added PCPs can use the study’s findings to encourage parents to promote habits such as exercise and healthy eating. – by Janel Miller

CDC. BMI Percentile Calculator for Child and Teen: Results on a Growth Chart.

https://nccd.cdc.gov/dnpabmi/ResultGraph.aspx?age=0&gender=0&ht=0&wt=0&method=0&dob=10/17/1994&dom=6/30/2014&inchtext=&wttext=&pagetype=graph. Accessed Oct. 23, 2017.

Disclosures : Okubo reports the study was funded by grants from Japan’s Ministry of Health, Labor and Welfare. Healio Family Medicine was unable to determine the other authors’ relevant disclosures prior to publication.