An Analysis of Obesity and Asthma Morbidity in Patients Managed at the Children's Hospital at Montefiore's Asthma Center.
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Gary K. Soffer, MD, Jennifer Toh, MD, Sunit P. Jariwala, MD, Deepa Rastogi, MD
Rationale: Previous studies suggest a relationship between obesity and childhood asthma. We investigated the impact of body weight and clinic visit compliance on asthma morbidity.

Methods: We reviewed 45 charts of children with moderate to severe persistent asthma seen at the Montefiore Asthma Center (MAC), a multidisciplinary center comprised of Allergy, Pulmonary, and Asthma Education servicesPatients had or more asthma-related emergency department (ED) visit or hospitalization or 3 or more steroid courses within 12 months of their first visit. Patients were categorized as obese/overweight (n=24) and normal-weight (n=21), based on CDC guidelines. Between-group comparisons were done for compliance with MAC appointments, asthma-related hospitalizations, and ED visits one year following the patient’s last visit. Compliance was defined as MAC visits.  

Results: Most patients lived in the Bronx (82%), were of minority ethnicities (37% Latino, 35% African-Americanand were obese/overweight (53%)Visit compliance was similar between both groups (50% obese/overweight vs. 48% normal-weight.). However, more obese/overweight patients (45%) were hospitalized the year following their last visit than normal-weight children (28%) with more hospitalizations  than normal-weight children (12 vs. 2, p=0.05). Similarly, 50% of obese/overweight patients had asthma-related ED visits the year following their last visit compared to 23% of normal-weight children  with more ED visits than normal-weight children (30 vs 10, p = 0.045).  

Conclusions: In spite of being compliant with asthma center evaluations, obese and overweight patients had more asthma-related ED visits and hospitalizations, suggesting continued higher asthma morbidity. This relationship requires further investigation as it may imply that obesity interventions might play a substantive role in asthma management.