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A2043 - Treatment of Asthma Exacerbation in Chilean Children: a Multicenter Observational Study
Author Block: A. M. Herrera1, G. Cavada2, Chilean Pediatric Asthma Working Group; 1Clínica Santa María, Santiago, Chile, 2Universidad de Chile, Santiago, Chile.
Background: asthma hospitalization rates in Chilean children has increased in the last 14 years. Limited information is available about asthma exacerbation treatment in hospitalized children. Objective: to describe asthma exacerbation treatment in different Chilean hospitals and evaluate the evolution of these patients 6 month after discharge. Methods: observational prospective cohort study in 14 tertiary care medical centers throughout Chile. Children 5 years of age or older hospitalized with an asthma exacerbation, during one year period, were eligible for inclusion in the study. Prior to discharge, investigators reviewed the included patients’ medical charts to evaluate different variables like the duration of the hospital stay, pharmacological treatments, isolated viruses and bacteria and medical complications. Six month after discharge we phone called patients to evaluate new asthma hospitalizations, emergency room visits, use of systemic corticosteroids and maintenance treatment. All the information was collected electronically and saved to a central database. Results: 396 patients were enrolled. Most patients (90%) were younger than 12 years of age. The mean duration of hospitalizations was 4 days. Almost all children received treatment with oxygen, short-acting beta agonists and systemic corticosteroids and 40,2% of them were treated with antibiotics. 69 patients (17.4%) were admitted to the Intensive Care Unit, of whom 46 (66.6%) used non invasive ventilation and 3 (4.3%) used invasive ventilation. We had 89 positive samples for any virus, the most common being Rhinovirus (56.2%) followed by Influenza Virus (12.4%). We obtained 23 positive samples for bacteria, 21 of them corresponding to Mycoplasma Pneumoniae. We had 123 complications, 49.6% of them were Atelectasis and 41.5% were Pneumonia. No death were reported. Six month after discharge 26.2% of patients were not using any controller treatment, 24.5% had received at least one course of systemic corticosteroids, 22.0% had visited the Emergency Room and 2.4% had had a new hospitalization for an exacerbation. Conclusions: the treatment of asthma exacerbation in hospitalized children is very similar in the 14 participating hospitals, with the use of oxygen, short-acting beta agonists and systemic corticosteroids. We observed some differences in the treatment of patients admitted to Intensive Care Units. Almost one fourth of patients still presented poor asthma control with use of systemic corticosteroids and visits to the Emergency Room six month after discharge.