Time trends in acute childhood asthma in Basque Country, Spain.

To investigate recent changes in the epidemiology of acute asthma in children in a hospital setting, data from the Basque region of Bizkaia, Spain were reviewed for the period between 1987 and 1992. Over this period there was a 18% drop in hospital emergency visits for asthma in children aged 2-14 years from 1,697/100,000 to 1,382/100,000. It was associated with a decline in the number of annual episodes per patient and in the number of patients needing further hospital treatment for the same episode. Paradoxically, hospital admission rates rose by 35.9% from 298/100,000 to 405/100,000. A trend toward decreasing length of hospital stay, a fall in the number of intensive care unit admissions, and an absence of in-hospital deaths were observed. Comparing data from September 1987 with those of September 1992, a trend has been noticed toward greater intensity of emergency room treatment with increases in the number of doses of nebulized beta 2-agonists administered and in courses of oral prednisolone given. In September 1992 more patients were on maintenance "anti-inflammatory" inhaled therapy than in 1987.