|
SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
11/8/06
Does chronic inhaled steroid therapy affect hospitalizations for acute asthma?
Summary
Background – Treatment with adequate doses of inhaled corticosteroids (ICS) in moderate to severe persistent asthma (PA) in children has been found to help prevent acute asthma exacerbations (AAE) that require hospitalization. But what is the effect of chronic ICS treatment if such asthmatic children have to be hospitalized because of an AAE?
Findings – Carroll et al of the Connecticut Children’s Med Center in Hartford, CT carried out an 8 year retrospective chart review of all children hospitalized in the ICU because of an AAE (n=241). In the 44% of such children who had been previously receiving chronic ICS, there was no significant difference in the course of the AAE when such children were compared to children who had not received chronic ICS prior to hospitalization. The course of the AAE was defined in this study by 1) duration of stay in the ICU; 2) treatments received and 3) rate of recovery from the AAE (determined by a standard severity scoring system)
Reference
Pediatr Pulmonol 2006;41:1213-17
Editor's Comments
The authors of this report concluded that chronic ICS therapy may prevent occurrences of AAE but do not affect the course of an AAE once it occurs. However, this retrospective uncontrolled study may have been confounded by the fact that the children on chronic ICS therapy had increased baseline severity of their asthma and more frequent previous asthma hospitalizations. Thus, the two study sub-groups (prior ICS treated vs no ICS treated) were not matched for baseline asthma severity. Therefore, one might expect the children receiving chronic ICS therapy to do worse when admitted with an AAE.
|