Abstract:
Introduction. - The frequency of emergency department visits
for asthma is a major public health problem in pediatrics. The aim of
this study is to identify the characteristics of children who visit the
pediatric emergency department for asthma exacerbation and to evaluate
their therapeutic management before admission.
Methods. - A prospective study conducted over a 6-month period
in the pediatric emergency departments of 5 hospitals on children aged 1
to 16 years who were admitted to the department with a clinical
diagnosis of asthma exacerbation.
Results. – 143 patients were enrolled in the study. Asthma
episodes were moderate to severe in 69.2% of cases (n = 99). Initial
therapeutic treatment before admission to the emergency department was
appropriate in 17.5% of cases (n = 25). Hospitalizations greater than
24 hours only occurred in 18.2% ( n = 26) . In children under 3 years
of age, the viral context was present in 91.4% (n = 64) &
exacerbations were more severe in younger patients (P = 0.002) and
economically disadvantaged children (P = 0.025). Only 17.4% (n=25) were
found to be positive by an antigen test or PCR test for SARS-CoV-2.
suggesting that the involvement of traditional respiratory viruses in
asthma exacerbation continues even in pandemic times.
Regarding the pre-hospital care, 70.6% (n=101) had received prior
treatment, but this treatment was inappropriate in 53.1 % (n=76).
Conclusions. - This study shows that asthmatic children and
their families know little about the disease and that physicians are not
sufficiently aware of current recommendations for the management of
asthmatic children. Admission to the emergency department for asthma
could be partially avoided by better diagnosis and therapeutic
education.
Keywords: asthma, asthma exacerbation, children, demographics,
risk