New research was presented at AAAAI 2017, the American Academy of Allergy, Asthma & Immunology Annual Meeting, from March 3 to 6 in Atlanta. The features below highlight some of the studies presented at the conference.
Maternal Vitamin E Levels & Asthma Risk
Previous research suggests there is a relationship between respiratory outcomes and isoforms of vitamin E, but little is known about the relationship between children’s risk for asthma and their mothers’ postpartum vitamin E levels. For a study, investigators examined data on more than 650 children with maternal postpartum plasma vitamin E isoforms measured at enrollment. Children and mothers were followed for the first 2 years of the child’s life. Children who wheezed were more likely to have mothers with significantly lower postpartum concentrations of vitamin E isoform alpha-tocopherol than those who did not wheeze. Children born to mothers with low vitamin E levels were also more likely to require asthma medication at 2 years.
Examining Disparities in Asthma Deaths
Previous studies indicate that African Americans experience a substantially higher rate of asthma-related mortality than Hispanics and Caucasians. Few studies have explored the reason(s) behind this disparity. Study investigators examined the place of death—out of hospital, outpatient, or inpatient—of children with asthma as the underlying cause of death between 2003 and 2014 from a national database. Outpatient deaths declined during the study period for Caucasian children, as did out-of-hospital deaths for African-American and Hispanic children. Inpatient deaths increased for all ethnic groups. However, African-American children were six times more likely to die from asthma than Hispanic or Caucasian children, and African-American children accounted for a significantly higher proportion of deaths than Caucasian children in all settings.
Predicting Hospital Readmission in COLD Patients
Data are lacking on early readmission rates among patients with chronic obstructive lung disease (COLD). As part of a study of hospital patients admitted with a primary diagnosis of asthma or COPD, collectively defined as COLD, researchers analyzed age- and mortality-adjusted comorbidities as risk factors for 30-day readmission. Among more than 5,700 COLD patients, 18.6% were readmitted within 30 days. Patients who were readmitted were significantly more likely to die during the study period 4.1% vs 2.7%, respectively). Chronic rhinitis was identified as the most significant predictor of 30-day readmission, followed by cardiac arrhythmia, obesity, anemia, tobacco use, and diabetes.
Bronchial Thermoplasty in High-Risk Asthma Patients
Previous research establishing the FDA approval of bronchial thermoplastly excluded high-risk asthma patients because of safety concerns. However, this patient population has higher levels of disease burden, fewer effective treatment options, and higher hospitalization rates when compared with asthma patients not excluded from this research. For a study, researchers examined treatment experiences of patients who did not meet inclusion criteria for bronchial thermoplastly. Nearly 100 patients underwent bronchial thermoplastly during general anesthesia or conscious sedation. Procedural complications occurred in just four patients and there were no cases of postoperative respiratory failure. Furthermore, only 28% of patients involved in the study experienced complications over the 6 weeks after treatment with bronchial thermoplastly.
Penicillin Allergy & Testing: Assessing Patient Awareness
Clinicians working in a general allergy clinic observed that although 25% of their patients had chart-reported penicillin allergy, penicillin testing was rarely performed in those who presented for non-drug allergy complaints. For a study, these clinicians created a one-page handout providing patient education about penicillin allergy and testing, with nurses providing the handout to all penicillin-allergic patients. An attached, five-question form assessed their prior knowledge of penicillin allergy and asked if they were interested in being tested. All patients who received the handout completed the survey. Among them, 70% did not know the allergy could be lost over time, 82% were not informed by their primary care provider that penicillin allergy testing was available, all expressed some interest in testing and found the handout useful, and 81% planned to or were scheduled for testing. Of 15 patients who underwent testing, 14 had negative skin testing results, tolerated an oral challenge, and were cleared of their allergy.
The Toll of Chronic Rhinosinusitis
Chronic rhinosinusitis is a highly prevalent, burdensome condition that has been linked to substantial healthcare utilization, but epidemiologic data derived from primary population sources are lacking. For a study, investigators collected information on more than 10,000 randomly sampled adults who participated in a population-based survey. Among those who fit the criteria for a chronic rhinosinusitis diagnosis with or without nasal polyps, 87% to 99% visited a doctor or took prescription medication (for nasal symptoms) in the prior 12 months. Despite available interventions, 41% with nasal polyps and 33% without remained “extremely” bothered by symptoms. More than half (54%) believed their symptoms were controlled, but 79% were concerned about flare-ups. Overall, 80% of survey respondents were frustrated by their inadequate symptom relief.
NEWS FROM AAAAI 2017
MORE FROM AAAAI 2017