Risk factors for hospitalisation due to exacerbations among adult asthma patients in a district of Sri Lanka: a case control study

Abstract

Background Exacerbations of asthma are a leading contributor to hospitalisations. Information on risk factors for hospitalisations due to exacerbated asthma will help to identify high-risk asthma patients for specialised care. We aimed to identify the risk factors for ‘hospitalisations due to exacerbations’ among adult asthma patients in a district of Sri Lanka. Methods A hospital-based, case-control study was carried out among asthma patients aged ≥ 20 years. Sample of 466 asthma patients (116 cases, 350 controls) recruited from all tertiary care hospitals in the district. Data were collected by pre-intern Medical Officers via pre-tested interviewer administered questionnaire on asthma control, asthma co-morbidities, risk behaviors, physiological and sociodemographic factors. Risk factors were evaluated using bivariate and multivariate logistic regression. Data were analyzed using SPSS version 20. Results Risk factors were; age ≥ 60 years (OR 2.1; 95% CI 1.2–3.7), educated G.C.E. O/Level or less (OR 2.2; 95% CI 1.1–4.4), having diabetes mellitus (OR 2.0; 95% CI 1.1–3.7), having symptomatic Gastroesophageal Reflux Disease (GORD) (OR 3.4; 95% CI 1.8–6.4), exposure to vehicular traffic (OR 3.2; 95%CI 1.8–5.7), exposure to secondhand tobacco smoke (OR 2.1; 95% CI 1.2–3.5), having ever smoked (OR 2.4; 95% CI 1.2–4.6), ever intubated/given ICU care (OR 3.5; 95% CI 1.5-8.0), previous hospitalizations due to exacerbations (OR 5.5; 95% CI 2.6–11.4), having uncontrolled asthma (OR 3.4; 95% CI 1.6–7.1) and BMI ≥ 25kg/m² (OR 2.3; 95% CI 1.4-4.0). Conclusions Preventive strategies need to address the modifiable risk factors: smoking, and obesity and manage comorbid conditions: diabetes and symptomatic GORD appropriately in asthma patients.