Secondhand Smoke Exposure and Illness Severity among Children Hospitalized with Pneumonia

Anna Ahn, Kathryn M. Edwards, Carlos G. Grijalva, Wesley H. Self, Yuwei Zhu, James D. Chappell, Sandra Arnold, Jonathan Mccullers, Krow Ampofo, Andrew T. Pavia, Anna M. Bramley, Seema Jain, Derek J. Williams

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective To assess the relationship between secondhand smoke (SHS) exposure and disease severity among children hospitalized with community-acquired pneumonia (CAP). Study design Children hospitalized with clinical and radiographic CAP were enrolled between January 1, 2010, and June 30, 2012 at 3 hospitals in Tennessee and Utah as part of the Centers for Disease Control and Prevention's Etiology of Pneumonia in the Community study. Household SHS exposure was defined based on the number of smokers in the child's home. Outcomes included hospital length of stay, intensive care unit admission, and mechanical ventilation. Proportional hazards and logistic regression models were used to assess associations between SHS exposure and outcomes. All models were adjusted for age, sex, race/ethnicity, household education level, government insurance, comorbidities, enrollment site, year, and season. Results Of the 2219 children included in the study, SHS exposure was reported in 785 (35.4%), including 325 (14.8%) with ≥2 smokers in the home. Compared with nonexposed children, the children exposed to ≥2 smokers had longer length of stay (median, 70.4 hours vs 64.4 hours; adjusted hazard ratio, 0.85; 95% CI, 0.75-0.97) and were more likely to receive intensive care (25.2% vs 20.9%; aOR, 1.44; 95% CI, 1.05-1.96), but not mechanical ventilation. Outcomes in children exposed to only 1 household smoker were similar to those in nonexposed children. Conclusion Children hospitalized with CAP from households with ≥2 smokers had a longer length of stay and were more likely to require intensive care compared with children from households with no smokers, suggesting that they experienced greater pneumonia severity.

Original languageEnglish (US)
Pages (from-to)869-874.e1
JournalJournal of Pediatrics
Volume167
Issue number4
DOIs
StatePublished - Oct 1 2015

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Tobacco Smoke Pollution
Hospitalized Child
Pneumonia
Length of Stay
Critical Care
Artificial Respiration
Logistic Models
Centers for Disease Control and Prevention (U.S.)
Insurance
Intensive Care Units
Comorbidity
Education

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Ahn, A., Edwards, K. M., Grijalva, C. G., Self, W. H., Zhu, Y., Chappell, J. D., ... Williams, D. J. (2015). Secondhand Smoke Exposure and Illness Severity among Children Hospitalized with Pneumonia. Journal of Pediatrics, 167(4), 869-874.e1. https://doi.org/10.1016/j.jpeds.2015.06.049

Secondhand Smoke Exposure and Illness Severity among Children Hospitalized with Pneumonia. / Ahn, Anna; Edwards, Kathryn M.; Grijalva, Carlos G.; Self, Wesley H.; Zhu, Yuwei; Chappell, James D.; Arnold, Sandra; Mccullers, Jonathan; Ampofo, Krow; Pavia, Andrew T.; Bramley, Anna M.; Jain, Seema; Williams, Derek J.

In: Journal of Pediatrics, Vol. 167, No. 4, 01.10.2015, p. 869-874.e1.

Research output: Contribution to journalArticle

Ahn, A, Edwards, KM, Grijalva, CG, Self, WH, Zhu, Y, Chappell, JD, Arnold, S, Mccullers, J, Ampofo, K, Pavia, AT, Bramley, AM, Jain, S & Williams, DJ 2015, 'Secondhand Smoke Exposure and Illness Severity among Children Hospitalized with Pneumonia', Journal of Pediatrics, vol. 167, no. 4, pp. 869-874.e1. https://doi.org/10.1016/j.jpeds.2015.06.049
Ahn, Anna ; Edwards, Kathryn M. ; Grijalva, Carlos G. ; Self, Wesley H. ; Zhu, Yuwei ; Chappell, James D. ; Arnold, Sandra ; Mccullers, Jonathan ; Ampofo, Krow ; Pavia, Andrew T. ; Bramley, Anna M. ; Jain, Seema ; Williams, Derek J. / Secondhand Smoke Exposure and Illness Severity among Children Hospitalized with Pneumonia. In: Journal of Pediatrics. 2015 ; Vol. 167, No. 4. pp. 869-874.e1.
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abstract = "Objective To assess the relationship between secondhand smoke (SHS) exposure and disease severity among children hospitalized with community-acquired pneumonia (CAP). Study design Children hospitalized with clinical and radiographic CAP were enrolled between January 1, 2010, and June 30, 2012 at 3 hospitals in Tennessee and Utah as part of the Centers for Disease Control and Prevention's Etiology of Pneumonia in the Community study. Household SHS exposure was defined based on the number of smokers in the child's home. Outcomes included hospital length of stay, intensive care unit admission, and mechanical ventilation. Proportional hazards and logistic regression models were used to assess associations between SHS exposure and outcomes. All models were adjusted for age, sex, race/ethnicity, household education level, government insurance, comorbidities, enrollment site, year, and season. Results Of the 2219 children included in the study, SHS exposure was reported in 785 (35.4{\%}), including 325 (14.8{\%}) with ≥2 smokers in the home. Compared with nonexposed children, the children exposed to ≥2 smokers had longer length of stay (median, 70.4 hours vs 64.4 hours; adjusted hazard ratio, 0.85; 95{\%} CI, 0.75-0.97) and were more likely to receive intensive care (25.2{\%} vs 20.9{\%}; aOR, 1.44; 95{\%} CI, 1.05-1.96), but not mechanical ventilation. Outcomes in children exposed to only 1 household smoker were similar to those in nonexposed children. Conclusion Children hospitalized with CAP from households with ≥2 smokers had a longer length of stay and were more likely to require intensive care compared with children from households with no smokers, suggesting that they experienced greater pneumonia severity.",
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AU - Edwards, Kathryn M.

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AU - Zhu, Yuwei

AU - Chappell, James D.

AU - Arnold, Sandra

AU - Mccullers, Jonathan

AU - Ampofo, Krow

AU - Pavia, Andrew T.

AU - Bramley, Anna M.

AU - Jain, Seema

AU - Williams, Derek J.

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N2 - Objective To assess the relationship between secondhand smoke (SHS) exposure and disease severity among children hospitalized with community-acquired pneumonia (CAP). Study design Children hospitalized with clinical and radiographic CAP were enrolled between January 1, 2010, and June 30, 2012 at 3 hospitals in Tennessee and Utah as part of the Centers for Disease Control and Prevention's Etiology of Pneumonia in the Community study. Household SHS exposure was defined based on the number of smokers in the child's home. Outcomes included hospital length of stay, intensive care unit admission, and mechanical ventilation. Proportional hazards and logistic regression models were used to assess associations between SHS exposure and outcomes. All models were adjusted for age, sex, race/ethnicity, household education level, government insurance, comorbidities, enrollment site, year, and season. Results Of the 2219 children included in the study, SHS exposure was reported in 785 (35.4%), including 325 (14.8%) with ≥2 smokers in the home. Compared with nonexposed children, the children exposed to ≥2 smokers had longer length of stay (median, 70.4 hours vs 64.4 hours; adjusted hazard ratio, 0.85; 95% CI, 0.75-0.97) and were more likely to receive intensive care (25.2% vs 20.9%; aOR, 1.44; 95% CI, 1.05-1.96), but not mechanical ventilation. Outcomes in children exposed to only 1 household smoker were similar to those in nonexposed children. Conclusion Children hospitalized with CAP from households with ≥2 smokers had a longer length of stay and were more likely to require intensive care compared with children from households with no smokers, suggesting that they experienced greater pneumonia severity.

AB - Objective To assess the relationship between secondhand smoke (SHS) exposure and disease severity among children hospitalized with community-acquired pneumonia (CAP). Study design Children hospitalized with clinical and radiographic CAP were enrolled between January 1, 2010, and June 30, 2012 at 3 hospitals in Tennessee and Utah as part of the Centers for Disease Control and Prevention's Etiology of Pneumonia in the Community study. Household SHS exposure was defined based on the number of smokers in the child's home. Outcomes included hospital length of stay, intensive care unit admission, and mechanical ventilation. Proportional hazards and logistic regression models were used to assess associations between SHS exposure and outcomes. All models were adjusted for age, sex, race/ethnicity, household education level, government insurance, comorbidities, enrollment site, year, and season. Results Of the 2219 children included in the study, SHS exposure was reported in 785 (35.4%), including 325 (14.8%) with ≥2 smokers in the home. Compared with nonexposed children, the children exposed to ≥2 smokers had longer length of stay (median, 70.4 hours vs 64.4 hours; adjusted hazard ratio, 0.85; 95% CI, 0.75-0.97) and were more likely to receive intensive care (25.2% vs 20.9%; aOR, 1.44; 95% CI, 1.05-1.96), but not mechanical ventilation. Outcomes in children exposed to only 1 household smoker were similar to those in nonexposed children. Conclusion Children hospitalized with CAP from households with ≥2 smokers had a longer length of stay and were more likely to require intensive care compared with children from households with no smokers, suggesting that they experienced greater pneumonia severity.

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