Associate Professor of Clinical Pediatrics Montefiore Medical Center Teaneck, New Jersey, United States
Background: Smoke originating from Canadian wildfires affected NYC air quality and raised the air quality index (AQI) during the spring and summer of 2023. The effect of wildfire smoke exposure on children with asthma in the Bronx is unknown. Objective: This study aimed to evaluate the effect of increased AQI secondary to smoke emitted from Canadian wildfires on pediatric hospital admission length of stay (LOS) for status asthmaticus in the Bronx, NY. LOS is a commonly used proxy of asthma exacerbation severity and healthcare cost. Design/Methods: We performed a retrospective review of children admitted to the Children’s Hospital at Montefiore for status asthmaticus from May 5-July 29, 2023. These dates were selected for analysis based on days NYC was intermittently affected by wildfire smoke. Demographic and clinical parameters were obtained from review of medical records. Fine particulate matter (PM2.5) measurements during the studied dates were acquired from local air quality sites. Children were placed in wildfire (AQI>50) or non-wildfire (AQI < 50) groups based on day of admission. Mean LOS was calculated for these groups. A second LOS analysis was performed using different cohorts divided based on AQI the day prior to admission rather than day of admission, as hospitalization can lag behind exposures and onset of symptoms. A subgroup analysis was performed for children admitted on days with the highest severity of AQI >101. Student t-test was used to compare LOS amongst these groups. Results: 117 children were included for analysis. Demographics for the 2 primary groups are provided in the Table. Overall mean LOS was 2.12 days. Mean LOS for children in non-wildfire group was 1.97 days compared to LOS for the wildfire group of 2.4 days (p=0.17). On secondary analysis, where cohorts were created based on AQI the day prior to admission rather than day of admission, LOS in the non-wildfire group was 2.17 days vs. 1.98 days in wildfire group. (p=0.55). LOS for children admitted on days with AQI >101 (n=5) was 3.01 days.
Conclusion(s): Lengthier hospital stays were noted for children admitted on days with higher AQI during the Canadian wildfire event. While almost half a day LOS increase was not statistically significant in our study, this increase still has a significant economic impact on both hospital cost and lost work and school days for families. Further investigation is needed for children admitted on AQI days >101.
