The impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities: a population-based observational study.

Simone Accordini,Angelo Guido Corsico,Pietro Pirina,Roberto Bono,Roberto de Marco,Alessandro Fois,Isa Cerveri,Roberta Tassinari,Lucia Calciano,Giuseppe Verlato

doi:10.1186/s12890-015-0008-0

Abstract

BackgroundChronic respiratory diseases are a significant cause of morbidity and mortality worldwide. We sought to evaluate the impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities in adults.MethodsIn the Gene Environment Interactions in Respiratory Diseases study (2007/2010), a screening questionnaire was mailed to 9,739 subjects aged 20–44 (response rate: 53.0%) and to 3,480 subjects aged 45–64 (response rate: 62.3%), who were randomly selected from the general population in Italy. The questionnaire was used to: identify the responders who had asthma, chronic bronchitis, allergic rhinitis or asthma-like symptoms/dyspnoea/other nasal problems; evaluate the total burden [use of hospital services (at least one ED visit and/or one hospital admission) and number of days with reduced activities (lost working days and days with limited, not work related activities) due to any health problems (apart from accidents and injuries) in the past three months]; evaluate the contribution of breathing problems to the total burden (hospitalizations and number of days with reduced activities specifically due to breathing problems).ResultsAt any age, the all-cause hospitalization risk was about 6% among the subjects without any respiratory conditions, it increased to about 9-12% among the individuals with allergic rhinitis or with asthma-like symptoms/dyspnoea/other nasal problems, and it peaked at about 15-18% among the asthmatics with chronic bronchitis aged 20–44 and 45–64, respectively. The expected number of days with reduced activities due to any health problems increased from 1.5 among the subjects with no respiratory conditions in both the age classes, to 6.3 and 4.6 among the asthmatics with chronic bronchitis aged 20–44 and 45–64, respectively. The contribution of breathing problems to the total burden was the highest among the asthmatics with chronic bronchitis (23-29% of the hospitalization risk and 39-50% of the days with reduced activities, according to age).ConclusionsThe impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities is substantial, and it is markedly different among adults from the general population in Italy. The contribution of breathing problems to the total burden also varies according to the respiratory condition.

Highlights

Chronic respiratory diseases are a significant cause of morbidity and mortality worldwide
The risk of all-cause hospitalization was about 6% among the subjects with no respiratory conditions, it increased to about 9-12% among the individuals reporting allergic rhinitis or asthma-like symptoms/dyspnoea/other nasal problems, and it peaked at about 15-18% among the asthmatics with chronic bronchitis aged 20–44 and 45– 64, respectively (Figure 2)
The expected number of days with reduced activities due to any health problems in the past three months was 2.4 (95%CI: 2.3 to 2.5) and 2.3 (95%CI: 2.1 to 2.5) among the subjects aged 20–44 and 45–64, respectively. This estimate increased from 1.5 days among the individuals with no respiratory conditions in both the age classes, to 6.3 and 4.6 days among the asthmatics with chronic bronchitis aged 20– 44 and 45–64, respectively (Figure 2)

Summary

Introduction

Chronic respiratory diseases are a significant cause of morbidity and mortality worldwide. We sought to evaluate the impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities in adults. Asthma generates a high socio-economic burden among European adults, which significantly increases when chronic bronchitis is present [11,12]. Asthma and allergic rhinitis together account for most of the allergy-related morbidity associated with the respiratory system [13]. In many studies, the total burden (i.e. the burden due to any health problems) in patients with these respiratory illnesses has not been estimated because only disease-related costs have been considered. The total burden should be compared between patients with a certain disease and unaffected subjects from the general population. A better understanding of the burden of these respiratory diseases requires the assessment of their total impact on the health and social systems

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