Follow-up study on factors influencing the persistence of asthma in discharged children

BACKGROUND: The process of asthma, after its onset, is featured by periods of persistence, relapse and remission. This follow-up study is aim to investigate the landscape of asthma management and personal factors associated with persistence and remission in children aged 0-18 years at Beijing Children's Hospital. METHODS: This was a retrospective cohort study. Children hospitalized in Beijing Children's Hospital from 2019 to 2021 due to acute asthma attacks were included as study participants. A questionnaire was used to collect information on both asthma management and the occurrence of any asthma attacks following discharge. We defined asthma remission as the absence of asthma symptoms for one year, in contrast to persistent asthma. Logistic regression analyses were performed to identify factors associated with asthma remission and persistence. RESULTS: A total of 210 children with asthma were enrolled in this study. Of these, 152 (72.4%) completed the follow-up and were included in the final analysis. The median follow-up time was 2.76 years (interquartile range (IQR), 2.18-3.95). Among these patients, the frequency of asthma attacks after discharge varied with different follow-up duration. 31.6% of children with asthma had regular follow-up visits, 36.8% had regular use of inhaled corticosteroids (ICS) for 3 months or more, and 42.8% used ICS only for asthma symptoms. There were 75 children with remission of asthma and 77 children with persistence. Multivariate logistic regression analysis identified three factors associated with asthma persistence: allergic rhinitis (odds ratio (OR) = 3.88, 95% confidence interval (CI): 1.54-9.75), ≥ 3 exacerbations in Early Period (OR = 12.34, 95% CI: 4.74-32.14) and unplanned healthcare attendances in Early Period (OR = 8.61, 95% CI: 2.51-29.51). CONCLUSIONS: After discharge, some children had acute asthma attacks. About 30% were engaged in regular follow-up and anti-asthma treatment. 50.7% of the children with asthma have experienced persistent asthma symptoms in the past year. Allergic rhinitis, ≥ 3 acute asthma attacks in Early Period, and unplanned healthcare attendances in Early Period were associated with asthma persistence.