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Araştırma Makalesi
BibTex RIS Kaynak Göster

1991-1995 yıllarında Dr. Sami Ulus Çocuk Sağlığı ve Hastalıkları Merkezi'ne yatan bronşial astımlı hastaların retrospektif değerlendirilmesi

Yıl 2018, Cilt: 3 Sayı: 2, 77 - 84, 30.08.2018

Yusuf Adnan Guclu

https://doi.org/10.22391/fppc.391343

Öz



Giriş: Astım, genellikle kronik hava yolu inflamasyonu ile karakterize
heterojen bir hastalıktır. Bronşiyal astım çocukluk çağının en yaygın kronik
hastalığıdır ve çocukların hastaneye sık yatış nedenleri arasındadır. Bu
çalışma ile 5 yıllık bir süre içerisinde“Bronşiyal astım” tanısıyla hastaneye
yatan hastaların demografik ve klinik özelliklerinin tanımlanarak
değerlendirilmesi amaçlanmıştır.



Yöntem
Doktor Sami Ulus Çocuk Hastalıkları Merkezine, 1991-1995 yıllan
arasında, Bronşiyal astım tanısıyla yatırılan 0-15 yaş arası hastaların
kayıtları incelendi. Hastaların sosyodemografik özellikleri, deri ve
laboratuvar değerleri ve aldıkları ilaç tedavileri incelendi.



Bulgular
Toplam 135 hastanın %58,5’i (n=79) erkekti. Hastaneye yatış yapılan
hastalarda yaş dağılımı en çok %57,8 (n=78) ile 3-5 yaş grubuna aitti. Ortalama
yıllık yatış oranı. %5,3 bulundu. Beş gün ve üzeri yatan hastalar en büyük
grubu oluşturuyordu (%39,3; n=53).Yatan hastaların çoğu (%74,1; n=100) kentsel
yerleşimliydi. Akciğer grafilerinde en sık görülen patolojik durum havalanma
artışı + infiltrasyonun bir arada olduğu durumdu (%52; n=70). Sinüzit %78,5
oranda yatışlara eşlik ediyordu. Hemogramda %50,4 ( n=68 ) lökositoz vardı. En
çok duyarlı deri testleri, karma çayır polenleri ve ev tozuydu. Profilaktik
tedavide öncelikle ketotifen kullanılıyordu. Acil serviste en fazla salbutamol,
serviste teofilin ve antibiyotik; taburcu edilen hastalarda ise en fazla
salbutamol şurup reçete edilmekteydi.



Sonuç: Araştırma grubunda erkek cinsiyetin ve 3-5 yaş grubunun daha fazla
olması, bunların önceki literatürle uyumlu risk faktörleri olduğunu
göstermiştir. Yıllık yatış oranlarının yıllara göre benzer olması, hastanenin
hizmet verdiği popülasyonda astım sıklığında zamanla bir değişiklik olmadığını
göstermektedir. Bronşiyal astımda sinüzit gibi antibiyotik kullanımını
gerektiren durumlar fazla olmakla birlikte, yine de antibiyotik kullanım
oranını düşürülmesi gerektiğine inanıyoruz.



Anahtar Kelimeler

Çocuk astım epidemiyoloji antibiyotik atopi

Kaynakça

  • 1. Global Initiative For Asthma (GINA). Global Strategy For Asthma Management and Prevention. Glob Initiat Asthma 2017:http://ginasthma.org/2017-gina-report-global-strat. doi: https://doi.org/10.1183/09031936.00138707
  • 2. Masoli M, Fabian D, Holt S, Beasley R. The global burden of asthma: Executive summary of the GINA Dissemination Committee Report. Allergy Eur J Allergy Clin Immunol 2004;59:469–78. doi: https://doi.org/10.1111/j.1398-9995.2004.00526.x
  • 3. Barış IY. Epidemiyoloji. In: Barış IY, editor. Bronchial asthsı. 1st ed. Ankara: Türkiye akciğer hastalıkarı vakfı yayınları; 1991, p. 1–7.
  • 4. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü. Chronic airway disease (Asthma-COPD) prevention program, action plan, Turkey (2009-2013). Ankara: Kuban Matbaacılık; 2009.
  • 5. Hamzaçebi H, Ünsal M, Kayhan S, Bilgin S, Ercan S. Prevalence of asthma and respiratory symptoms by age, gender and smoking behaviour in Samsun, North Anatolia Turkey 2006;54:322–9.
  • 6. Akcay A, Tamay Z, Dağdeviren E, Zencir M, Ones U, Güler N. Denizli ’deki 6-7 yaş okul çocuklarında allerjik hastalıklarının prevalansları. The prevalences of allergic diseases symptoms among 6-7 yr-old school children in Denizli. Ege Tıp Derg 2007;46:145–50.
  • 7. Simpson CR, Sheikh A. Trends in the epidemiology of asthma in England: A national study of 333,294 patients. J R Soc Med 2010;103:98–106. doi: https://doi.org/10.1258/jrsm.2009.090348
  • 8. Türktaş H, Türktaş İ. Bronchial asthma in children. 1st ed. Ankara: Bozkır matbaacılık; 1998.
  • 9. Bisgaard H, Szefler S. Prevalence of asthma-like symptoms in young children. Pediatr Pulmonol 2007;42:723–8. doi: https://doi.org/10.1002/ppul.20644
  • 10. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and Wheezing in the First Six Years of Life. N Engl J Med 1995;332:133–8. doi: https://doi.org/10.1056/NEJM199501193320301
  • 11. Kuehni CE, Strippoli MPF, Low N, Brooke AM, Silverman M. Wheeze and asthma prevalence and related health-service use in white and south Asian pre-schoolchildren in the United Kingdom. Clin Exp Allergy 2007;37:1738–46. doi: https://doi.org/10.1111/j.1365-2222.2007.02784.x
  • 12. Sly PD, Boner AL, Björksten B, et al. Early identification of atopy in the prediction of persistent asthma in children. Lancet 2008;372:1100–6. doi: https://doi.org/10.1016/S0140-6736(08)61451-8
  • 13. Caudri D, Wijga A, A. Schipper CM, et al. Predicting the long-term prognosis of children with symptoms suggestive of asthma at preschool age. J Allergy Clin Immunol 2009;124. doi: https://doi.org/10.1016/j.jaci.2009.06.045
  • 14. Vollmer WM, Osborne ML, Buist AS. Temporal trends in hospital-based episodes of asthma care in a health maintenance organization. Am Rev Respir Dis 1993;147:347–53. doi: https://doi.org/10.1164/ajrccm/147.2.347
  • 15. Yakari S. Assessment of asthma risk factors in children with food allergy. Hacettepe Üniversitesi Tıp Fakültesi, 2012.
  • 16. Friday GA, Fireman P. Morbidity and mortality of asthma. Pediatr Clin North Am 1988;35:1149–62. doi: https://doi.org/10.1016/S0031-3955(16)36554-3
  • 17. Parks DP, Ahrens RC, Humphries CT, Weinberger MM. Chronic cough in childhood: approach to diagnosis and treatment. J Pediatr 1989;115:856–62.
  • 18. Gerstman BB, Bosco LA, Tomita DK. Trends in the prevalence of asthma hospitalization in the 5- to 14-year-old Michigan Medicaid population, 1980 to 1986. J Allergy Clin Immunol 1993;91:838–43. doi: https://doi.org/10.1016/0091-6749(93)90340-L
  • 19. Gottlieb DJ, Beiser AS, O’Connor GT. Poverty, race, and medication use are correlates of asthma hospitalization rates: A small area analysis in Boston. Chest 1995;108:28–35. doi: https://doi.org/10.1378/chest.108.1.28
  • 20. National institutes of Health. Global Strategy for Asthma Management and Prevention. 1995.
  • 21. Mutlu B, Balcı S. Asthma risk factors, clinical features, and prevention in children. TAF Prev Med Bull 2010;9:79–96.
  • 22. Arshad SH, Matthews S, Gant C, Hide DW. Effect of allergen avoidance on development of allergic disorders in infancy. Lancet 1992;339:1493–7. doi: https://doi.org/10.1016/0140-6736(92)91260-F
  • 23. Valet RS, Gebretsadik T, Carroll KN, et al. High asthma prevalence and increased morbidity among rural children in a Medicaid cohort. Ann Allergy, Asthma Immunol 2011;106:467–73. doi: https://doi.org/10.1016/j.anai.2011.02.013
  • 24. Lawson JA, Janssen I, Bruner MW, Madani K, Pickett W. Urban-rural differences in asthma prevalence among young people in Canada: The roles of health behaviors and obesity. Ann Allergy, Asthma Immunol 2011;107:220–8. doi: https://doi.org/10.1016/j.anai.2011.06.014
  • 25. Pesek RD, Vargas PA, Halterman JS, Jones SM, McCracken A, Perry TT. A comparison of asthma prevalence and morbidity between rural and urban schoolchildren in Arkansas. Ann Allergy, Asthma Immunol 2010;104:125–31. doi: https://doi.org/10.1016/j.anai.2009.11.038
  • 26. Taylor WR, Newacheck PW. Impact of childhood asthma on health. Pediatrics 1992;90:657–62.
  • 27. Roorda RJ, Gerritsen J, Vanaalderen WMC, et al. Risk-Factors for the Persistence of Respiratory Symptoms in Childhood Asthma. Am Rev Respir Dis 1993;148:1490–5. doi: https://doi.org/10.1164/ajrccm/148.6_Pt_1.1490
  • 28. Reed CE. The natural history of asthma. J Allergy Clin Immunol 2006;118:543–8. doi: https://doi.org/10.1016/j.jaci.2006.06.020
  • 29. Rachelefsky GS, Katz RM, Siegfel SC. Chronic sinus disease with associated reactive airway disease in children. Pediatrics 1984;73:526–9.
  • 30. Arslan Z, Teziç T, Laleli Y, Yurdakul A, Evliyaoğlu O. The value of diagnostic methods in airway allergy. Turkiye Klin J Pediatr 1993;2(3):132-135.
  • 31. Seber O. Pulmonary function tests in asthma. In: Barış İY, editor. Bronş astması., Ankara: Türkiye akciğer hastalıkarı vakfı yayınları; 1991, p. 117–41.
  • 32. Scarfone RJ, Fuchs SM, Nager AL, Shane SA. Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma. Pediatrics 1993;92:513–8.
  • 33. Strauss RE, Wertheim DL, Bonagura VR, Valacer DJ. Aminophylline therapy does not improve outcome and increases adverse effects in children hospitalized with acute asthmatic exacerbations. Pediatrics 1994;93:205–10.
  • 34. Roorda RJ, Gerritsen J, van Aalderen WM, et al. Follow-up of asthma from childhood to adulthood: influence of potential childhood risk factors on the outcome of pulmonary function and bronchial responsiveness in adulthood. J Allergy Clin Immunol 1994;93:575–84. Doi: https://dx.doi.org/10.1016/S0091-6749(94)70069-9

Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics

Yıl 2018, Cilt: 3 Sayı: 2, 77 - 84, 30.08.2018

Yusuf Adnan Guclu

https://doi.org/10.22391/fppc.391343

Öz

Introduction: Asthma is a heterogeneous disease characterized by chronic airway
inflammation. Bronchial asthma ‎is the most common chronic disease of childhood
and is among the causes of frequent hospitalization in children. ‎This study
aims to describe the demographic and clinical characteristics of the patients
hospitalized due to ‎‎"bronchial asthma" within five years.

Methods: The hospital records of patients aged 0-15 years admitted with the
diagnosis of bronchial asthma to the Dr. Sami Ulus Center for Pediatrics
between 1991-1995 were examined. The sociodemographic characteristics, ‎skin,
and laboratory values of the patients and the medications they received were
examined. ‎

Results: Of the total 135 patients, 58.5% (n = 79) were males. The age
distribution of the inpatients was mostly in ‎the age group of 3-5 years
(57.8%, n = 78). The mean annual hospitalization rate was 0.53%. Patients
‎hospitalized for five days composed the largest group (39.3%, n = 53). Most of
the hospitalized patients (74.1%; n = ‎‎100) were coming from urban settings.
The most common pathologic condition on chest X-ray were increased ‎aeration +
infiltration (52%, n = 70). Sinusitis was accompanied to 78.5% of the
hospitalizations. There was ‎‎50.4% (n = 68) leukocytosis in the hemograms.
Most sensitive skin tests were mixed grass pollen and house dust. ‎The primary
medication used in prophylactic treatments was Ketotifen. Salbutamol was the
most common ‎medication used in the emergency department, theophylline and
antibiotics for the bedside, and salbutamol syrup ‎was the most prescribed
medication for the discharged patients.‎







Conclusion: The greater proportion of male gender and 3-5 year-olds in the study
group indicated that these risk ‎factors were consistent with the previous
literature. The similarity of annual admission rates within the years indicates
‎that there is no change in asthma frequency in the population served over time.
Even though the number of cases ‎requiring antibiotics in bronchial asthma is
high (similar to sinusitis), we believe that the use of antibiotics should be
‎lowered. ‎

Anahtar Kelimeler

Child asthma epidemiology antibiotics atopy

Kaynakça

  • 1. Global Initiative For Asthma (GINA). Global Strategy For Asthma Management and Prevention. Glob Initiat Asthma 2017:http://ginasthma.org/2017-gina-report-global-strat. doi: https://doi.org/10.1183/09031936.00138707
  • 2. Masoli M, Fabian D, Holt S, Beasley R. The global burden of asthma: Executive summary of the GINA Dissemination Committee Report. Allergy Eur J Allergy Clin Immunol 2004;59:469–78. doi: https://doi.org/10.1111/j.1398-9995.2004.00526.x
  • 3. Barış IY. Epidemiyoloji. In: Barış IY, editor. Bronchial asthsı. 1st ed. Ankara: Türkiye akciğer hastalıkarı vakfı yayınları; 1991, p. 1–7.
  • 4. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü. Chronic airway disease (Asthma-COPD) prevention program, action plan, Turkey (2009-2013). Ankara: Kuban Matbaacılık; 2009.
  • 5. Hamzaçebi H, Ünsal M, Kayhan S, Bilgin S, Ercan S. Prevalence of asthma and respiratory symptoms by age, gender and smoking behaviour in Samsun, North Anatolia Turkey 2006;54:322–9.
  • 6. Akcay A, Tamay Z, Dağdeviren E, Zencir M, Ones U, Güler N. Denizli ’deki 6-7 yaş okul çocuklarında allerjik hastalıklarının prevalansları. The prevalences of allergic diseases symptoms among 6-7 yr-old school children in Denizli. Ege Tıp Derg 2007;46:145–50.
  • 7. Simpson CR, Sheikh A. Trends in the epidemiology of asthma in England: A national study of 333,294 patients. J R Soc Med 2010;103:98–106. doi: https://doi.org/10.1258/jrsm.2009.090348
  • 8. Türktaş H, Türktaş İ. Bronchial asthma in children. 1st ed. Ankara: Bozkır matbaacılık; 1998.
  • 9. Bisgaard H, Szefler S. Prevalence of asthma-like symptoms in young children. Pediatr Pulmonol 2007;42:723–8. doi: https://doi.org/10.1002/ppul.20644
  • 10. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and Wheezing in the First Six Years of Life. N Engl J Med 1995;332:133–8. doi: https://doi.org/10.1056/NEJM199501193320301
  • 11. Kuehni CE, Strippoli MPF, Low N, Brooke AM, Silverman M. Wheeze and asthma prevalence and related health-service use in white and south Asian pre-schoolchildren in the United Kingdom. Clin Exp Allergy 2007;37:1738–46. doi: https://doi.org/10.1111/j.1365-2222.2007.02784.x
  • 12. Sly PD, Boner AL, Björksten B, et al. Early identification of atopy in the prediction of persistent asthma in children. Lancet 2008;372:1100–6. doi: https://doi.org/10.1016/S0140-6736(08)61451-8
  • 13. Caudri D, Wijga A, A. Schipper CM, et al. Predicting the long-term prognosis of children with symptoms suggestive of asthma at preschool age. J Allergy Clin Immunol 2009;124. doi: https://doi.org/10.1016/j.jaci.2009.06.045
  • 14. Vollmer WM, Osborne ML, Buist AS. Temporal trends in hospital-based episodes of asthma care in a health maintenance organization. Am Rev Respir Dis 1993;147:347–53. doi: https://doi.org/10.1164/ajrccm/147.2.347
  • 15. Yakari S. Assessment of asthma risk factors in children with food allergy. Hacettepe Üniversitesi Tıp Fakültesi, 2012.
  • 16. Friday GA, Fireman P. Morbidity and mortality of asthma. Pediatr Clin North Am 1988;35:1149–62. doi: https://doi.org/10.1016/S0031-3955(16)36554-3
  • 17. Parks DP, Ahrens RC, Humphries CT, Weinberger MM. Chronic cough in childhood: approach to diagnosis and treatment. J Pediatr 1989;115:856–62.
  • 18. Gerstman BB, Bosco LA, Tomita DK. Trends in the prevalence of asthma hospitalization in the 5- to 14-year-old Michigan Medicaid population, 1980 to 1986. J Allergy Clin Immunol 1993;91:838–43. doi: https://doi.org/10.1016/0091-6749(93)90340-L
  • 19. Gottlieb DJ, Beiser AS, O’Connor GT. Poverty, race, and medication use are correlates of asthma hospitalization rates: A small area analysis in Boston. Chest 1995;108:28–35. doi: https://doi.org/10.1378/chest.108.1.28
  • 20. National institutes of Health. Global Strategy for Asthma Management and Prevention. 1995.
  • 21. Mutlu B, Balcı S. Asthma risk factors, clinical features, and prevention in children. TAF Prev Med Bull 2010;9:79–96.
  • 22. Arshad SH, Matthews S, Gant C, Hide DW. Effect of allergen avoidance on development of allergic disorders in infancy. Lancet 1992;339:1493–7. doi: https://doi.org/10.1016/0140-6736(92)91260-F
  • 23. Valet RS, Gebretsadik T, Carroll KN, et al. High asthma prevalence and increased morbidity among rural children in a Medicaid cohort. Ann Allergy, Asthma Immunol 2011;106:467–73. doi: https://doi.org/10.1016/j.anai.2011.02.013
  • 24. Lawson JA, Janssen I, Bruner MW, Madani K, Pickett W. Urban-rural differences in asthma prevalence among young people in Canada: The roles of health behaviors and obesity. Ann Allergy, Asthma Immunol 2011;107:220–8. doi: https://doi.org/10.1016/j.anai.2011.06.014
  • 25. Pesek RD, Vargas PA, Halterman JS, Jones SM, McCracken A, Perry TT. A comparison of asthma prevalence and morbidity between rural and urban schoolchildren in Arkansas. Ann Allergy, Asthma Immunol 2010;104:125–31. doi: https://doi.org/10.1016/j.anai.2009.11.038
  • 26. Taylor WR, Newacheck PW. Impact of childhood asthma on health. Pediatrics 1992;90:657–62.
  • 27. Roorda RJ, Gerritsen J, Vanaalderen WMC, et al. Risk-Factors for the Persistence of Respiratory Symptoms in Childhood Asthma. Am Rev Respir Dis 1993;148:1490–5. doi: https://doi.org/10.1164/ajrccm/148.6_Pt_1.1490
  • 28. Reed CE. The natural history of asthma. J Allergy Clin Immunol 2006;118:543–8. doi: https://doi.org/10.1016/j.jaci.2006.06.020
  • 29. Rachelefsky GS, Katz RM, Siegfel SC. Chronic sinus disease with associated reactive airway disease in children. Pediatrics 1984;73:526–9.
  • 30. Arslan Z, Teziç T, Laleli Y, Yurdakul A, Evliyaoğlu O. The value of diagnostic methods in airway allergy. Turkiye Klin J Pediatr 1993;2(3):132-135.
  • 31. Seber O. Pulmonary function tests in asthma. In: Barış İY, editor. Bronş astması., Ankara: Türkiye akciğer hastalıkarı vakfı yayınları; 1991, p. 117–41.
  • 32. Scarfone RJ, Fuchs SM, Nager AL, Shane SA. Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma. Pediatrics 1993;92:513–8.
  • 33. Strauss RE, Wertheim DL, Bonagura VR, Valacer DJ. Aminophylline therapy does not improve outcome and increases adverse effects in children hospitalized with acute asthmatic exacerbations. Pediatrics 1994;93:205–10.
  • 34. Roorda RJ, Gerritsen J, van Aalderen WM, et al. Follow-up of asthma from childhood to adulthood: influence of potential childhood risk factors on the outcome of pulmonary function and bronchial responsiveness in adulthood. J Allergy Clin Immunol 1994;93:575–84. Doi: https://dx.doi.org/10.1016/S0091-6749(94)70069-9
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Yusuf Adnan Guclu 0000-0001-7121-8961

Yayımlanma Tarihi 30 Ağustos 2018
Gönderilme Tarihi 7 Şubat 2018
Kabul Tarihi 9 Nisan 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 3 Sayı: 2

Kaynak Göster

APA Guclu, Y. A. (2018). Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics. Family Practice and Palliative Care, 3(2), 77-84. https://doi.org/10.22391/fppc.391343
AMA Guclu YA. Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics. Fam Pract Palliat Care. Ağustos 2018;3(2):77-84. doi:10.22391/fppc.391343
Chicago Guclu, Yusuf Adnan. “Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics”. Family Practice and Palliative Care 3, sy. 2 (Ağustos 2018): 77-84. https://doi.org/10.22391/fppc.391343.
EndNote Guclu YA (01 Ağustos 2018) Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics. Family Practice and Palliative Care 3 2 77–84.
IEEE Y. A. Guclu, “Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics”, Fam Pract Palliat Care, c. 3, sy. 2, ss. 77–84, 2018, doi: 10.22391/fppc.391343.
ISNAD Guclu, Yusuf Adnan. “Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics”. Family Practice and Palliative Care 3/2 (Ağustos2018), 77-84. https://doi.org/10.22391/fppc.391343.
JAMA Guclu YA. Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics. Fam Pract Palliat Care. 2018;3:77–84.
MLA Guclu, Yusuf Adnan. “Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics”. Family Practice and Palliative Care, c. 3, sy. 2, 2018, ss. 77-84, doi:10.22391/fppc.391343.
Vancouver Guclu YA. Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics. Fam Pract Palliat Care. 2018;3(2):77-84.
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