Childhood asthma increases respiratory morbidity, but not all-cause mortality in adulthood: The Busselton Health Study.,Respiratory Medicine

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Childhood asthma increases respiratory morbidity, but not all-cause mortality in adulthood: The Busselton Health Study.
Respiratory Medicine ( IF 3.5 ) Pub Date : 2020-07-28 , DOI: 10.1016/j.rmed.2020.106095
Christopher A C M Ng ₁ , Matthew W Knuiman ₂ , Kevin Murray ₂ , Mark L Divitini ₂ , Arthur W Bill Musk ₂ , Alan L James ₃

Affiliation

Background

Long-term childhood asthma studies that investigate adult outcomes other than lung function are lacking. This study examines the associations of childhood asthma and the occurrence of respiratory events and all-cause mortality in adulthood.

Methods

A cohort of 4430 school children (aged to 17 years) who attended the Busselton Health Study between 1967 and 1983 were analysed. Self-reported history of asthma was determined using questionnaires. Participants were followed until 2014 for respiratory disease-related events (hospital admissions or death) and all-cause mortality using the Western Australia Data Linkage System. Cox regression models were used to investigate the impact of childhood asthma on respiratory events and all-cause mortality in adulthood. A subgroup of 2153 participants who re-attended a survey in young adulthood was also analysed.

Results

A total of 462 (10%) of the cohort had childhood asthma. During follow-up 791 participants experienced a respiratory event and 140 participants died. Childhood asthma was associated with an increased risk of respiratory events in adulthood (unadjusted HR 1.84, 95% CI 1.52 to 2.23; P < 0.0001). The result remained significant after adjusting for adult-onset asthma, FEV₁, body mass index, smoking, dusty job, hay fever, and respiratory symptoms (adjusted HR 1.68, 95% CI 1.07 to 2.64; P = 0.0247). Childhood asthma was not associated with all-cause mortality in adulthood (unadjusted HR 1.08, 95% CI 0.63 to 1.84; P = 0.7821).

Conclusion

Childhood asthma is associated with increased risk of respiratory disease-related hospital admissions and death but not all-cause mortality in adulthood.

中文翻译：

儿童哮喘会增加呼吸系统疾病的发病率，但不会增加成年后的全因死亡率：Busselton Health Study。

背景

缺乏长期的儿童哮喘研究，研究除肺功能以外的成人结局。这项研究检查了儿童哮喘与成年期呼吸事件和全因死亡率的关系。

方法

分析了1967年至1983年之间参加巴瑟尔顿健康研究的4430名学龄儿童（年龄在17岁以下）。使用调查表确定自我报告的哮喘病史。使用西澳大利亚州数据链接系统对参与者进行随访直至2014年，以进行呼吸道疾病相关事件（医院入院或死亡）和全因死亡率。使用Cox回归模型研究儿童哮喘对成年期呼吸事件和全因死亡率的影响。还分析了2153名参加青年成年调查的参与者的亚组。

结果

共有462名（10％）队列患有儿童哮喘。在随访期间，有791名参与者经历了呼吸事件，有140名参与者死亡。儿童哮喘与成年期呼吸事件风险增加相关（HR调整前为1.84，95％CI为1.52至2.23；P <0.0001）。调整成人发作的哮喘，FEV ₁，体重指数，吸烟，多尘的工作，花粉症和呼吸道症状后，结果仍然很显着（HR调整为1.68，95％CI为1.07至2.64；P = 0.0247）。儿童哮喘与成年期全因死亡率无关（HR 1.08，95％CI 0.63至1.84；P = 0.7821）。