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Asthma Exacerbations in the Pediatric Emergency Department at a Tertiary Hospi-tal: Relationship with Environmental Factors

Marques-Mejías MA1, Tomás-Pérez M1,2, Hernández I1, López I1, Quirce S1,2,3

1Department of Allergy, Hospital Universitario La Paz, Madrid, Spain.
2Department of Allergy, Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain.
3CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain.

J Investig Allergol Clin Immunol 2019; Vol. 29(5)
doi: 10.18176/jiaci.0364

Introduction: Children with asthma suffer from recurrent respiratory symptoms and ex-acerbations due to multiple environmental factors. The aim of this study is to describe the prevalence and triggers of asthma exacerbations and their management in cohort of pediatric patients attended in an emergency department (ED).
Methods: This was an observational, retrospective, single center study, conducted in the pediatric ED of the Hospital Universitario La Paz (Madrid, Spain) in 2015. Children with asthma exacerbations attending the ED were included in the study after a thorough search using our institution informatics database. Pollen and atmospheric mold spore counts as well as pollution data were collected for that period from official websites. Mul-tiple logistic regression was used to assed the association between daily pollution (de-termine by levels NO2, PM10, O3, pollen and mold counts) and asthma admissions in the ED.
Results: During 2015, 50,619 patients attended the ED of our hospital. Of these, 2,609 (5%) had the diagnosis of asthma exacerbation/bronchospasm. The 21.7% of the cases required hospital admission. The main triggers of asthma exacerbations were respiratory infections in 1,841 of cases (70.6%). A significant correlation was found between grass pollen counts and ED admissions (p<10-4). A positive correlation was also found between ED admissions and NO2 0.58 (95% 0.02 to 0.87) and PM10 0.75 (95% 0.31 to 0.93) (p<0.05).
Conclusion: Environmental factors such as grass pollen counts and pollution (NO2 and PM10) are associated with more ED admissions. 

Key words: Pediatric Asthma, Asthma Exacerbations, Air Pollutants, Asthma Management.