Sensitization to indoor allergens and the risk for asthma hospitalization in children.

BACKGROUND: Hospitalization for asthma continues to present a major health problem despite advances in our understanding that asthma is an inflammatory disease of the bronchi and that exposure to specific allergens can induce and worsen this inflammation. The role of sensitization to specific indoor allergens and hospitalization for acute asthma in children is unclear.

OBJECTIVE: The purpose of this study was to evaluate the independent contributions of sensitization to specific indoor allergens among children with asthma to the risk of hospitalization for asthma.

METHODS: The charts of 138 consecutive children with asthma, aged 5 to 18 years, seen at pediatric allergy clinics were reviewed to obtain the results of skin tests to cat, dog, cockroach, and dust mite allergens and the history of hospitalization for asthma within the year prior to the clinic visit. Logistic regression analysis was used to examine the association between indoor allergen sensitivity and other factors, and the risk of hospitalization for asthma.

RESULTS: In univariate analyses, hospitalization for asthma was significantly associated with cockroach sensitivity (odds ratio [OR] = 2.2; 95% confidence interval [CI] = 1.1, 4.3); cat sensitivity (OR = 2.9; CI = 1.3, 6.4); black race (OR = 2.4; CI = 1.1, 5.1); public aid/self pay (OR = 2.3; CI 1.1, 4.9) and age, (OR [per year increase in age] = 0.8; CI = 0.7, 0.9). In a stepwise multiple logistic regression analysis, only cat sensitivity (OR = 3.8; CI = 1.5, 9.2), age (OR = 0.8; CI = 0.7, 0.9) and race (OR = 3.2; CI = 1.4, 7.5) entered into the model as significant independent predictors.

CONCLUSION: Sensitivity to cat allergen may be an important determinant for asthma hospitalization in children. Sensitization to cockroach allergen per se was not found to be an independent risk factor. As observed in previous studies, younger and black children were at increased risk of hospitalization for asthma.