WIP 161 - Comparing Outcomes of a Single Dose of Dexamethasone vs. Systemic Corticosteroids After Initial Dose of Dexamethasone in Children Hospitalized for Acute Asthma Exacerbation
Fellow Cohen Children's Medical Center Roslyn, New York, United States
Background: Asthma is the most common chronic disease in pediatrics. In addition to bronchodilators, asthma exacerbations are routinely treated with corticosteroids to reduce airway inflammation. Previously, prednisone or prednisolone were the steroids of choice for an acute exacerbation. Dexamethasone, however, has recently been studied in the ED setting, and similar outcomes in regards to relapse rate have been seen with a 1-to-2-day course of dexamethasone as compared to a 3-to-5-day course of prednisone or prednisolone. Objective: The purpose of this study was to examine if there was a significant difference in relapse rate among children admitted to an inpatient unit with a primary diagnosis of an acute asthma exacerbation who were treated with different steroid regimens. Design/Methods: We performed a single site retrospective cohort study of children ages 2 to 18 years admitted to Cohen Children’s Medical Center from January 1, 2016 to December 31, 2020 with a primary discharge diagnosis of status asthmaticus or an acute asthma exacerbation. Only children who were treated with an initial dose of dexamethasone as their first systemic steroid were included. Children were excluded if they were transferred from a hospital outside of our health system, admitted to the PICU, or had a complex chronic condition. The primary outcome was relapse rate, defined as: bronchodilator given at an outpatient visit, ED revisit within 7 days, or hospital re-admission within 7 days. A univariable analysis was performed to test for association between relapse rate and different steroid regimens.
