Caracterización de la severidad de crisis asmática en niños y adolescentes que aumentaron la hospitalización en un hospital pediátrico de tercer nivel en Barranquilla (Atlántico)
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Fecha
2024
Autores
Acevedo Cerchiaro , María Nurys
Fragozo Messino, Stacey Johana
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Ediciones Univerisdad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción: El asma es una patología crónica muy frecuente en pediatría, la
prevalencia viene en aumento. Las exacerbaciones de asma no solo impactan de manera negativa a la familia sino también a los sistemas de salud. Objetivo: Caracterizar la severidad de crisis asmática que favorecen a la hospitalización en niños y adolescentes que ingresaron en un hospital pediátrico de Barranquilla. Métodos: Es un estudio analítico, retrospectivo de corte longitudinal en un hospital pediátrico de Barranquilla. La base de datos fue desde el 1 enero 2019 hasta el 31 diciembre 2023 (prepandemia, emergencia covid, poscovid), se identificaron y analizaron factores sociodemográficos, factores desencadenantes, comorbilidad,
riesgo de hospitalización y severidad de crisis asmáticas mediante el score
pulmonary; comparando los tres periodos de tiempo (prepandemia, emergencia covid y emergencia poscovid), seguidamente se describieron las variables, se construyeron matrices de frecuencia con variables cualitativas, se determinaron diferencias significativas de las variables en los tres periodos mediante la prueba de Chi2 o test Exacto de Fisher según el caso. Se realizó Chi2 entre el uso de corticoide y frecuencia o no de hospitalizaciones en el total de datos y en cada uno de los periodos de tiempo.
Resultados: La frecuencia de crisis asmática por score pulmonary leve fue la más frecuente, el sexo masculino (pα:0.05 = 0.032) y los paciente en edad preescolar predominaron en el estudio, se incrementó la hospitalización durante y después de pandemia; las comorbilidades no fueron determinantes de gravedad ni motivo de hospitalización; el uso de corticoide previo fue menor antes de la pandemia y se vio relacionado con la hospitalización (pα:0.05 = 0.0097); se disminuyó el PAI durante y después de la pandemia, la exposición a clima frio ( pα:0.05 = 0.00) y contaminantes (pα:0.05 = 0.0102) se disminuyó, Barranquilla fue el lugar de mayor procedencia, el estado nutricional que predomino fue el adecuado, no hubo variación con la lactancia materna exclusiva en los tres periodo de tiempo Conclusión: La exacerbación de asma se asocia al sexo masculino y en mayor proporción en la edad preescolar, es importante el uso correcto de corticoide, el abuso del mismo puede provocar alteración en el sistema inmune e inducir a más infección, por último la pandemia indujo rechazo sobre las vacunas.
Introduction: Asthma is a very common chronic pathology in pediatrics, the prevalence is increasing. Asthma exacerbations not only negatively impact the family but also health systems. Objective: To characterize the severity of asthma attacks that favor hospitalization in children and adolescents admitted to a pediatric hospital in Barranquilla. Methods: It is an analytical, retrospective, longitudinal study in a pediatric hospital in Barranquilla. Barranquilla. The database was from January 1, 2019 to December 31, 2023 (pre-pandemic, covid and post-covid emergency), sociodemographic factors, triggering factors, comorbidity, risk of hospitalization and severity of asthma attacks were identified and analyzed using the pulmonary score; Comparing the three time periods (pre-pandemic, covid emergency and post-covid emergency), the variables were then described, frequency matrices were constructed with qualitative variables, significant differences of the variables in the three periods were determined using the Chi2 test or Exact test. of Fisher as the case may be. Chi2 was performed between the use of corticosteroid and frequency or not of hospitalizations in the total data and in each of the time periods. Results: The frequency of asthma attacks due to mild pulmonary score was the most frequent, the male sex (pα:0.05 = 0.032) and preschool-age patients predominated in the study, hospitalization increased during and after the pandemic; comorbidities were not determinants of severity or reason for hospitalization; Previous corticosteroid use was lower before the pandemic and was related to hospitalization (pα:0.05 = 0.0097); The PAI was decreased during and after the pandemic, exposure to cold weather (pα:0.05 = 0.00) and pollutants (pα:0.05 = 0.0102) was decreased, Barranquilla was the place of greatest origin, the nutritional status that predominated was adequate, there was no variation with exclusive breastfeeding in the three time periods Conclusion: Asthma exacerbation is associated with the male sex and in a greater proportion in preschool age, the correct use of corticosteroid is important, its abuse can cause alteration in the immune system and induce more infection, finally the pandemic induced rejection of vaccines.
Introduction: Asthma is a very common chronic pathology in pediatrics, the prevalence is increasing. Asthma exacerbations not only negatively impact the family but also health systems. Objective: To characterize the severity of asthma attacks that favor hospitalization in children and adolescents admitted to a pediatric hospital in Barranquilla. Methods: It is an analytical, retrospective, longitudinal study in a pediatric hospital in Barranquilla. Barranquilla. The database was from January 1, 2019 to December 31, 2023 (pre-pandemic, covid and post-covid emergency), sociodemographic factors, triggering factors, comorbidity, risk of hospitalization and severity of asthma attacks were identified and analyzed using the pulmonary score; Comparing the three time periods (pre-pandemic, covid emergency and post-covid emergency), the variables were then described, frequency matrices were constructed with qualitative variables, significant differences of the variables in the three periods were determined using the Chi2 test or Exact test. of Fisher as the case may be. Chi2 was performed between the use of corticosteroid and frequency or not of hospitalizations in the total data and in each of the time periods. Results: The frequency of asthma attacks due to mild pulmonary score was the most frequent, the male sex (pα:0.05 = 0.032) and preschool-age patients predominated in the study, hospitalization increased during and after the pandemic; comorbidities were not determinants of severity or reason for hospitalization; Previous corticosteroid use was lower before the pandemic and was related to hospitalization (pα:0.05 = 0.0097); The PAI was decreased during and after the pandemic, exposure to cold weather (pα:0.05 = 0.00) and pollutants (pα:0.05 = 0.0102) was decreased, Barranquilla was the place of greatest origin, the nutritional status that predominated was adequate, there was no variation with exclusive breastfeeding in the three time periods Conclusion: Asthma exacerbation is associated with the male sex and in a greater proportion in preschool age, the correct use of corticosteroid is important, its abuse can cause alteration in the immune system and induce more infection, finally the pandemic induced rejection of vaccines.
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Palabras clave
Asma, Pediatría, Covid-19, Asthma, Pediatrics