Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012

Joe G. Zein, Belinda L. Udeh, W. Gerald Teague, Siran M. Koroukian, Nicholas K. Schlitz, Eugene R. Bleecker, William B. Busse, William Calhoun, Mario Castro, Suzy A. Comhair, Anne M. Fitzpatrick, Elliot Israel, Sally E. Wenzel, Fernando Holguin, Benjamin M. Gaston, Serpil C. Erzurum

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background Worldwide, asthma is a leading cause of morbidity, mortality and economic burden, with significant gender and racial disparities. However, little attention has been given to the independent role of age on lifetime asthma severity and hospitalization. We aimed to assess the effect of age, gender, race and ethnicity on indicators of asthma severity including asthma related hospitalization, mortality, hospital cost, and the rate of respiratory failure. Methods We analyzed the 2011 and 2012 Healthcare Cost and Utilization Project- National Inpatient Sample (NIS). We validated and extended those results using the National Heart, Lung, and Blood Institute-Severe Asthma Research Program (SARP; 2002-2011) database. Severe asthma was prospectively defined using the stringent American Thoracic Society (ATS) definition. Results Hospitalization for asthma was reported in 372,685 encounters in 2012 and 368,528 in 2011. The yearly aggregate cost exceeded $2 billion. There were distinct bimodal distributions for hospitalization age, with an initial peak at 5 years and a second at 50 years. Likewise, this bimodal age distribution of patients with severe asthma was identified using SARP. Males comprised the majority of individuals in the first peak, but women in the second. Aggregate hospital cost mirrored the bimodal peak distribution. The probability of respiratory failure increased with age until the age of 60, after which it continued to increase in men, but not in women. Conclusions Severe asthma is primarily a disease of young boys and middle age women. Greater understanding of the biology of lung aging and influence of sex hormones will allow us to plan for targeted interventions during these times in order to reduce the personal and societal burdens of asthma.

Original languageEnglish (US)
Article numbere0157301
JournalPLoS One
Volume11
Issue number6
DOIs
StatePublished - Jun 1 2016

Fingerprint

Hospital Costs
asthma
Asthma
gender
Costs
Hospitalization
Gonadal Steroid Hormones
Age Distribution
cell aggregates
Blood
Aging of materials
Respiratory Insufficiency
Economics
lungs
health care costs
National Heart, Lung, and Blood Institute (U.S.)
Mortality
sex hormones
nationalities and ethnic groups
research programs

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Zein, J. G., Udeh, B. L., Teague, W. G., Koroukian, S. M., Schlitz, N. K., Bleecker, E. R., ... Erzurum, S. C. (2016). Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012. PLoS One, 11(6), [e0157301]. https://doi.org/10.1371/journal.pone.0157301

Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012. / Zein, Joe G.; Udeh, Belinda L.; Teague, W. Gerald; Koroukian, Siran M.; Schlitz, Nicholas K.; Bleecker, Eugene R.; Busse, William B.; Calhoun, William; Castro, Mario; Comhair, Suzy A.; Fitzpatrick, Anne M.; Israel, Elliot; Wenzel, Sally E.; Holguin, Fernando; Gaston, Benjamin M.; Erzurum, Serpil C.

In: PLoS One, Vol. 11, No. 6, e0157301, 01.06.2016.

Research output: Contribution to journalArticle

Zein, JG, Udeh, BL, Teague, WG, Koroukian, SM, Schlitz, NK, Bleecker, ER, Busse, WB, Calhoun, W, Castro, M, Comhair, SA, Fitzpatrick, AM, Israel, E, Wenzel, SE, Holguin, F, Gaston, BM & Erzurum, SC 2016, 'Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012', PLoS One, vol. 11, no. 6, e0157301. https://doi.org/10.1371/journal.pone.0157301
Zein JG, Udeh BL, Teague WG, Koroukian SM, Schlitz NK, Bleecker ER et al. Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012. PLoS One. 2016 Jun 1;11(6). e0157301. https://doi.org/10.1371/journal.pone.0157301
Zein, Joe G. ; Udeh, Belinda L. ; Teague, W. Gerald ; Koroukian, Siran M. ; Schlitz, Nicholas K. ; Bleecker, Eugene R. ; Busse, William B. ; Calhoun, William ; Castro, Mario ; Comhair, Suzy A. ; Fitzpatrick, Anne M. ; Israel, Elliot ; Wenzel, Sally E. ; Holguin, Fernando ; Gaston, Benjamin M. ; Erzurum, Serpil C. / Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012. In: PLoS One. 2016 ; Vol. 11, No. 6.
@article{0ca1db9bf00f4f7d86faa3cb57fff599,
title = "Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012",
abstract = "Background Worldwide, asthma is a leading cause of morbidity, mortality and economic burden, with significant gender and racial disparities. However, little attention has been given to the independent role of age on lifetime asthma severity and hospitalization. We aimed to assess the effect of age, gender, race and ethnicity on indicators of asthma severity including asthma related hospitalization, mortality, hospital cost, and the rate of respiratory failure. Methods We analyzed the 2011 and 2012 Healthcare Cost and Utilization Project- National Inpatient Sample (NIS). We validated and extended those results using the National Heart, Lung, and Blood Institute-Severe Asthma Research Program (SARP; 2002-2011) database. Severe asthma was prospectively defined using the stringent American Thoracic Society (ATS) definition. Results Hospitalization for asthma was reported in 372,685 encounters in 2012 and 368,528 in 2011. The yearly aggregate cost exceeded $2 billion. There were distinct bimodal distributions for hospitalization age, with an initial peak at 5 years and a second at 50 years. Likewise, this bimodal age distribution of patients with severe asthma was identified using SARP. Males comprised the majority of individuals in the first peak, but women in the second. Aggregate hospital cost mirrored the bimodal peak distribution. The probability of respiratory failure increased with age until the age of 60, after which it continued to increase in men, but not in women. Conclusions Severe asthma is primarily a disease of young boys and middle age women. Greater understanding of the biology of lung aging and influence of sex hormones will allow us to plan for targeted interventions during these times in order to reduce the personal and societal burdens of asthma.",
author = "Zein, {Joe G.} and Udeh, {Belinda L.} and Teague, {W. Gerald} and Koroukian, {Siran M.} and Schlitz, {Nicholas K.} and Bleecker, {Eugene R.} and Busse, {William B.} and William Calhoun and Mario Castro and Comhair, {Suzy A.} and Fitzpatrick, {Anne M.} and Elliot Israel and Wenzel, {Sally E.} and Fernando Holguin and Gaston, {Benjamin M.} and Erzurum, {Serpil C.}",
year = "2016",
month = "6",
day = "1",
doi = "10.1371/journal.pone.0157301",
language = "English (US)",
volume = "11",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

TY - JOUR

T1 - Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012

AU - Zein, Joe G.

AU - Udeh, Belinda L.

AU - Teague, W. Gerald

AU - Koroukian, Siran M.

AU - Schlitz, Nicholas K.

AU - Bleecker, Eugene R.

AU - Busse, William B.

AU - Calhoun, William

AU - Castro, Mario

AU - Comhair, Suzy A.

AU - Fitzpatrick, Anne M.

AU - Israel, Elliot

AU - Wenzel, Sally E.

AU - Holguin, Fernando

AU - Gaston, Benjamin M.

AU - Erzurum, Serpil C.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Background Worldwide, asthma is a leading cause of morbidity, mortality and economic burden, with significant gender and racial disparities. However, little attention has been given to the independent role of age on lifetime asthma severity and hospitalization. We aimed to assess the effect of age, gender, race and ethnicity on indicators of asthma severity including asthma related hospitalization, mortality, hospital cost, and the rate of respiratory failure. Methods We analyzed the 2011 and 2012 Healthcare Cost and Utilization Project- National Inpatient Sample (NIS). We validated and extended those results using the National Heart, Lung, and Blood Institute-Severe Asthma Research Program (SARP; 2002-2011) database. Severe asthma was prospectively defined using the stringent American Thoracic Society (ATS) definition. Results Hospitalization for asthma was reported in 372,685 encounters in 2012 and 368,528 in 2011. The yearly aggregate cost exceeded $2 billion. There were distinct bimodal distributions for hospitalization age, with an initial peak at 5 years and a second at 50 years. Likewise, this bimodal age distribution of patients with severe asthma was identified using SARP. Males comprised the majority of individuals in the first peak, but women in the second. Aggregate hospital cost mirrored the bimodal peak distribution. The probability of respiratory failure increased with age until the age of 60, after which it continued to increase in men, but not in women. Conclusions Severe asthma is primarily a disease of young boys and middle age women. Greater understanding of the biology of lung aging and influence of sex hormones will allow us to plan for targeted interventions during these times in order to reduce the personal and societal burdens of asthma.

AB - Background Worldwide, asthma is a leading cause of morbidity, mortality and economic burden, with significant gender and racial disparities. However, little attention has been given to the independent role of age on lifetime asthma severity and hospitalization. We aimed to assess the effect of age, gender, race and ethnicity on indicators of asthma severity including asthma related hospitalization, mortality, hospital cost, and the rate of respiratory failure. Methods We analyzed the 2011 and 2012 Healthcare Cost and Utilization Project- National Inpatient Sample (NIS). We validated and extended those results using the National Heart, Lung, and Blood Institute-Severe Asthma Research Program (SARP; 2002-2011) database. Severe asthma was prospectively defined using the stringent American Thoracic Society (ATS) definition. Results Hospitalization for asthma was reported in 372,685 encounters in 2012 and 368,528 in 2011. The yearly aggregate cost exceeded $2 billion. There were distinct bimodal distributions for hospitalization age, with an initial peak at 5 years and a second at 50 years. Likewise, this bimodal age distribution of patients with severe asthma was identified using SARP. Males comprised the majority of individuals in the first peak, but women in the second. Aggregate hospital cost mirrored the bimodal peak distribution. The probability of respiratory failure increased with age until the age of 60, after which it continued to increase in men, but not in women. Conclusions Severe asthma is primarily a disease of young boys and middle age women. Greater understanding of the biology of lung aging and influence of sex hormones will allow us to plan for targeted interventions during these times in order to reduce the personal and societal burdens of asthma.

UR - http://www.scopus.com/inward/record.url?scp=84976427914&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976427914&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0157301

DO - 10.1371/journal.pone.0157301

M3 - Article

VL - 11

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 6

M1 - e0157301

ER -