3.1 | Exacerbations
Across all ages, approximately 22% of patients (n = 31) had SSC, and 42% (n = 56) were from a low-economic background. 60.1% (n = 86) of patients lived within 15 km of the hospital, second-hand smoke was reported for 54.9% (n = 73), and T2D was present in 68.1% of cases (n = 94) for all ages. The crisis occurred in the aftermath of an effort (n = 10) in 7% of cases (n = 10) and in the context of respiratory virus in 75.7% of cases (n = 106) at all ages. In children under three years of age, the viral context was present in 91.4% of cases (n = 64). Information collected on the severity of exacerbations upon admission to the emergency department, medical treatments implemented, and hospitalizations following management are summarized in Table 3.
Moderate and severe exacerbations were more common in children belonging to the youngest age groups (p = 0.002). Similarly, the average age was significantly lower (p < 0.001) in children with moderate to severe exacerbation on admission (3.5 ± 3.0 years) compared to those with a mild exacerbation (5.1 ± 3.6). Being from a low economic background was also a risk factor for severity of exacerbation (p = 0.025, OR: 1.13).
The relation between male sex and severity of exacerbations was not significant (p = 0.099), although boys were more represented in more severe exacerbations. Treatment in the emergency department included beta-2 agonist aerosols/more restricted nebulization (p < 0.001) and less frequently corticosteroid use (p < 0.001) in mild exacerbation. Multivariate analysis confirmed that moderate and severe exacerbations were more common under three years of age compared to the upper age group (p = 0.024). Low socioeconomic background represented a non-significant risk of severity of exacerbations (p = 0.061) (Table 4).