Published online October 1, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. 734-740 (doi:10.1542/peds.2007-0409)
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ARTICLE

Childhood Overweight Increases Hospital Admission Rates for Asthma

Christopher L. Carroll, MD, Petronella Stoltz, APRN, Neviana Raykov, APRN, Sharon R. Smith, MD and Aaron R. Zucker, MD

Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut

OBJECTIVES. Although childhood overweight has been associated with increased hospital lengths of stay for patients with asthma, the possible relationship between overweight and hospital admission for asthma has not been well studied. We hypothesized that overweight children who presented to the emergency department with asthma exacerbations were more likely to be admitted to the hospital than nonoverweight children.

METHODS. A retrospective chart review was conducted of all children who were older than 2 years and presented to the emergency department with an asthma exacerbation in calendar year 2005. Children with chronic medical conditions other than asthma were excluded. Children were classified as nonoverweight (≤95% weight-for-age percentile) or overweight (>95% weight for age).

RESULTS. During the study period, there were 884 visits to the emergency department for an asthma exacerbation by 813 children; 238 (27%) were admitted to the hospital, and 33 (4%) were admitted to the ICU. Overall, hospital admission was associated with higher clinical asthma score but not with age, gender, or poverty status (as quantified as home in zip-code areas designated as "impoverished"). Overweight children (n = 202 [23%]) were significantly older (8.5 ± 4.4 vs 7.3 ± 4.3 years) and more likely to live in an impoverished area (37% vs 28%). Presenting clinical asthma score and therapeutic interventions in the emergency department were similar for overweight and nonoverweight children; however, overweight children were significantly more likely to be admitted to the hospital.

CONCLUSIONS. Overweight children who present to the emergency department with acute asthma exacerbations are significantly more likely to be admitted to the hospital than nonoverweight children. This identifies an important area in which childhood overweight has a significant impact on the health of children with asthma.

Key Words: pediatrics • asthma • overweight • hospitalization

Abbreviations: ED—emergency department • MPIS—Modified Pulmonary Index Score • OR—odds ratio • CI—confidence interval

Accepted May 17, 2007.




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C. Gundersen, B. J. Lohman, S. Garasky, S. Stewart, and J. Eisenmann
Food Security, Maternal Stressors, and Overweight Among Low-Income US Children: Results From the National Health and Nutrition Examination Survey (1999-2002)
Pediatrics, September 1, 2008; 122(3): e529 - e540.
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