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

Abstract

Background The exacerbation of asthma is a leading contributor to hospitalization. Information on the risk factors for hospitalization due to exacerbated asthma will help to identify high-risk asthma patients for specialized care. We aimed to identify the risk factors for hospitalization due to exacerbations among adult asthma patients in a district of Sri Lanka. Methods A hospital-based, case‒control study was carried out on asthma patients aged ≥ 20 years. A total of 466 asthma patients (116 cases, 350 controls) were recruited from all tertiary care hospitals in the district. The data were collected by pre-intern medical officers via a pretested interviewer-administered questionnaire on asthma control, asthma comorbidities, risk behaviors, and physiological and sociodemographic factors. Risk factors were evaluated using bivariate and multivariate logistic regression. The data were analyzed using SPSS version 20. Results The 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 having a BMI ≥ 25 kg/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.