Comparative Effectiveness of Dexamethasone versus Prednisone in Children Hospitalized with Asthma

The Journal of Pediatrics
Kavita ParikhSamir S Shah

Abstract

To study the comparative effectiveness of dexamethasone vs prednisone/prednisolone in children hospitalized with asthma exacerbation not requiring intensive care. This multicenter retrospective cohort study, using the Pediatric Health Information System, included children aged 4-17 years who were hospitalized with a principal diagnosis of asthma between January 1, 2007 and December 31, 2012. Children with chronic complex condition and/or initial intensive care unit (ICU) management were excluded. Propensity score matching was used to detect differences in length of stay (LOS), readmissions, ICU transfer, and cost between groups. 40,257 hospitalizations met inclusion criteria; 1166 (2.9%) received only dexamethasone. In the matched cohort (N = 1284 representing 34 hospitals), the LOS was significantly shorter in the dexamethasone group compared with the prednisone/prednisolone group. The proportion of subjects with a LOS of 3 days or more was 6.7% in the dexamethasone group and 12% in the prednisone/prednisolone group (P = .002). Differences in all-cause readmission at 7- and 30 days were not statistically significant. The dexamethasone group had lower costs of index admission ($2621 vs $2838; P < .001) and total episode of care...Continue Reading

References

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Aug 27, 2014·Paediatric Respiratory Reviews·Guodong DingYixiao Bao

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Citations

Mar 18, 2017·Current Opinion in Pediatrics·Erin K StensonDerek S Wheeler
May 21, 2018·Archives of Disease in Childhood·Jiske Steensma, Chris Bird
Sep 25, 2018·Journal of Clinical Pharmacology·Michael L Christensen, Robert L Davis
Nov 1, 2018·Clinical Pediatrics·Angela S VolkNeel M Naik
Mar 3, 2020·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Annie Lintzenich AndrewsAlexander H Hogan
May 6, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jose IrazuztaSara L Dominguez
Sep 3, 2020·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Amy M DeLarocheAaron Jones
May 23, 2019·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Jillian M CotterHeather E Hoch
Jan 26, 2021·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Srish SharmaElizabeth Eby Halvorson
Mar 10, 2020·Pediatric Emergency Care·Robert Peterson, Kelly D Young
Oct 7, 2021·Hospital Pediatrics·Sunita Ali HemaniSarah Varghese

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