Factors associated with acute respiratory failure in childhood asthma

Abstract

Background : Asthma is the most common chronic diseases in children. Frequent exacerbation of asthma related to impairment of quality of life, limitation of physical activities, study performance, and also have morbidities such as respiratory failure and
mortality. The appropriate treatment, using controller, showed effectively reduce the burden of the disease. Even though have proper treatment, some of them still have severe asthmatic attack that causes acute respiratory failure.
Objective : To determine risk factors associated with acute respiratory failure in childhood asthma in Pattani province.
Materials : This prognostic factor retrospective case control design research was conducted at Pediatrics department of Pattani hospital in children aged 6 months – 15 years old ,who were diagnosed asthma, received controller and follow up in asthma clinic in Pattani province, since 1 January 2018 – 31 December 2022.
Methods : These childhood asthma were divided into 2 groups. Both of them were in asthma clinic and received controller. The first group was the patients who had respiratory failure event and the second group was the patient who did not have respiratory failure event. The data was gathered from medical records and referral information records. Data analysis of two groups were compared by Fisher exact probability test and weighted logistic regression for rare event .
Results : There were 18 childhood asthma who had respiratory failure and 72 childhood asthma who were treated simultaneously and in the same clinic but did not have respiratory failure event. The significant risk factors for acute respiratory failure included 1) malnutrition, weight for age below 60 percent (odds ratio [OR] 128.83, 95% CI 26.89-617.33) 2) comorbidities (odds ratio [OR] 8.44, 95% CI 0.67-106.07) 3) co-infection of respiratory tract (odds ratio [OR] 116.01, 95% CI 34.53-389.74), and 4) compliance of using controller, which loose more than a week (odds ratio [OR] 245.35, 95%CI 62.95-956.22).
Conclusion : Factors associated with acute respiratory failure in childhood asthma who had prescribed controller were severe malnutrition (weight for age < 60%), co-morbidities, coincident of respiratory tract infection and loose of controller more than a week.