Comparison of severity of asthma hospitalization between African American and Hispanic children in the Bronx

J Asthma. 2020 Jul;57(7):736-742. doi: 10.1080/02770903.2019.1609981. Epub 2019 May 7.

Abstract

Objective: There are racial and ethnic disparities in childhood asthma burden and outcomes. Although there have been comparisons between whites and minorities, there are few between minority groups. This study aimed to compare characteristics of asthma hospitalizations in African American and Hispanic children.Methods: A retrospective chart review was conducted to compare asthma characteristics between African American and Hispanic children aged 2-18 years hospitalized at an urban, tertiary care hospital for an acute asthma exacerbation. Length of stay (LOS), need for intensive care unit (ICU), and need for additional medications or respiratory support were compared between the groups.Results: Of the 925 children that met the inclusion criteria, 64% were Hispanic and 36% were African American. The groups were similar in age, gender, insurance status, and weight classification. African American children were more likely to have severe persistent asthma (12% vs. 7%, p = .02). They were also more likely to require magnesium sulfate (45% vs. 32%, p < .001) and admission to the ICU from the emergency department (ED) (14% vs. 8%, p = .01), which were independent of asthma severity. There was no significant difference in LOS or other characteristics of hospitalization.Conclusions: African American children hospitalized for asthma have more severe exacerbations compared to Hispanic children, which is independent of their asthma severity. However, this was not associated with longer LOS, which may indicate greater responsiveness to inpatient asthma management. Further investigation is needed to understand the mechanisms underlying asthma and exacerbation severity among minority groups.

Keywords: Inpatient; disparity; exacerbation; minority groups; urban.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Asthma / diagnosis*
  • Asthma / epidemiology
  • Asthma / therapy
  • Black or African American / statistics & numerical data*
  • Child
  • Child, Preschool
  • Female
  • Hispanic or Latino / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Magnesium Sulfate / therapeutic use
  • Male
  • Minority Groups / statistics & numerical data*
  • New York City / epidemiology
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • Severity of Illness Index*
  • Tertiary Care Centers / statistics & numerical data

Substances

  • Magnesium Sulfate