This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To determine the association between secondhand smoke (SHS) exposure and length of stay (LOS) and other exacerbation severity indicators in children hospitalized for asthma.
Methods: We conducted a retrospective chart review at 2 children’s hospitals. Patients aged 2 to 18 hospitalized for asthma in 2012 were included. Outcome variables included LOS, PICU, magnesium, and intravenous (IV) steroids. Bivariate analysis determined differences between SHS-exposed and non–SHS-exposed groups. Geometric means were used for LOS to account for skewed distribution. Logistic and zero-truncated negative binomial regression models were used to determine the independent association between SHS exposure and hospitalization severity indicators.
Results: A total of 623 patients were included; 41% reported SHS exposure. Mean LOS was 47.5 hours. In the SHS-exposed group, LOS was 50.0 (95% confidence interval [CI] 46.7–54.0) and in the nonexposed group it was 45.8 (95% CI 43.4–48.4) (P = .02). In regression analysis, institution modified the effect of SHS exposure on LOS. At Children’s Hospital Colorado, SHS exposure was associated with a 20% increase in LOS (incidence rate ratio 1.2, 95% CI 1.1–1.3). At the Medical University of South Carolina, there was no significant association. SHS-exposed patients were more likely to receive IV steroids (odds ratio 1.6, 95% CI 1.1–2.3)
Conclusions: Among children hospitalized for asthma, we identified a significant association at 1 institution between SHS exposure and LOS and found that IV steroid use was significantly associated with LOS at both institutions. Eliminating SHS exposure among children with asthma is important.
- CHCO
- Children’s Hospital Colorado
- CI
- confidence interval
- CPAP
- continuous positive airway pressure
- ED
- emergency department
- IRR
- incidence rate ratio
- IV
- intravenous
- LOS
- length of stay
- MUSC
- Medical University of South Carolina
- OR
- odds ratio
- PNA
- pulmonary nodular amyloidosis
- RedCap
- Research Electronic Data Capture
- SHS
- secondhand smoke
- Copyright © 2015 by the American Academy of Pediatrics
Individual Login
Institutional Login
You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.
Log in through your institution
Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00
Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.