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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Race/Ethnicity and Asthma Among Children Presenting to the Emergency Department: Differences in Disease Severity and Management
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Race/Ethnicity and Asthma Among Children Presenting to the Emergency Department: Differences in Disease Severity and Management

机译:向急诊科就诊的儿童的种族/民族和哮喘:疾病严重程度和管理上的差异

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Objective. To investigate racial/ethnic differences in acute asthma among children who present to the emergency department (ED).Method. We analyzed data from 2 prospective cohort studies performed during 1997–1998 as part of the Multicenter Airway Research Collaboration. Using a standardized protocol, researchers at 40 EDs in 18 US states provided 24-hour-per-day coverage for a median of 2 weeks per year. Children with acute asthma were interviewed in the ED and by telephone 2 weeks after discharge.Results. Among 1095 patients, 679 (62%) were black, 256 (23%) were Hispanic, and 160 (15%) were white. Black and Hispanic children had greater histories of lifetime (63%, 64%, 46%) and past-year (34%, 31%, 14%) hospitalization and more ED visits in the past year (medians: 2, 3, 1). Asthma severity at ED presentation, ED management and course, hospitalization during the index visit, discharge prescriptions, and postdischarge outcomes were equivalent among all race/ethnic groups.Conclusion. Despite pronounced race/ethnicity-based differences in chronic asthma, all racial/ethnic groups exhibited similar acute asthma severity, ED management, and course. However, given that black and Hispanic children exhibited much higher admission histories and past ED use, the equivalence in inhaled corticosteroid prescriptions on discharge is a disconcerting pattern that mirrors previous literature on outpatient prescription practices. In addition to barriers attributable to socioeconomic factors, health care providers and policy makers should target equalizing deficiencies in preventive medication prescription practices.
机译:目的。目的调查急诊科(ED)儿童急性哮喘的种族/种族差异。作为多中心气道研究合作的一部分,我们分析了1997年至1998年进行的2项前瞻性队列研究的数据。使用标准化协议,美国18个州的40 ED的研究人员提供了每天24小时的每日报道,平均每年2周。出院后2周,在急诊室和电话中采访了患有急性哮喘的儿童。在1095位患者中,黑人占679位(占62%),西班牙裔占256位(占23%),白人占160位(占15%)。黑人和西班牙裔儿童的一生(63%,64%,46%)和过去一年(34%,31%,14%)的住院病史较多,过去一年中有更多的急诊就诊史(中位数:2、3、1) )。在所有种族/族裔人群中,ED表现,ED管理和疗程,索引访视期间住院,出院处方和出院后结局的哮喘严重程度均相同。尽管在慢性哮喘中基于种族/族裔的差异明显,所有种族/族裔组均表现出相似的急性哮喘严重程度,ED处理和病程。但是,考虑到黑人和西班牙裔儿童的入院史和过去的ED使用情况要高得多,因此,出院时吸入皮质类固醇处方的等效性令人不安,与以前有关门诊处方做法的文献一致。除了可归因于社会经济因素的障碍外,医疗保健提供者和政策制定者还应针对预防性药物处方实践中的均等缺陷。

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