Cotinine in children admitted for asthma and readmission

Judie Ann Howrylak, Adam J. Spanier, Bin Huang, Roy W.A. Peake, Mark D. Kellogg, Hadley Sauers, Robert S. Kahn

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

OBJECTIVE: To explore the relationship between tobacco smoke exposure (reported versus biomarker) and rates of readmission for children hospitalized for asthma. METHODS: We enrolled a prospective cohort of 774 children aged 1 to 16 years admitted for asthma or bronchodilator-responsive wheezing. The primary outcome was at least 1 asthma- or wheeze-related readmission within 1 year. Caregivers reported any tobacco exposure at home, in a secondary residence, or in the car. We measured serum and saliva cotinine levels with mass spectrometry. We used logistic regression to evaluate associations between tobacco exposure and readmissions. RESULTS: A total of 619 children had complete tobacco exposure data; 57% were African American and 76% had Medicaid. Seventeen percent of children were readmitted within 1 year. Tobacco exposure rates were 35.1%, 56.1%, and 79.6% by report, serum, and saliva measures, respectively. Caregiver report of any tobacco exposure was not associated with readmission (adjusted odds ratio: 1.18; 95% confidence interval: 0.79-1.89), but having detectable serum or salivary cotinine was associated with increased odds of readmission (adjusted odds ratio [95% confidence interval]: 1.59 [1.02-2.48] and 2.35 [1.22-4.55], respectively). Among children whose caregivers reported no tobacco exposure, 39.1% had detectable serum cotinine and 69.9% had detectable salivary cotinine. Of the children with reported exposure, 87.6% had detectable serum cotinine and 97.7% had detectable salivary cotinine. CONCLUSIONS: Detectable serum and salivary cotinine levels were common among children admitted for asthma and were associated with readmission, whereas caregiver report of tobacco exposure was not.

Original languageEnglish (US)
JournalPediatrics
Volume133
Issue number2
DOIs
StatePublished - Feb 1 2014

Fingerprint

Cotinine
Tobacco
Asthma
Caregivers
Serum
Saliva
Odds Ratio
Confidence Intervals
Hospitalized Child
Bronchodilator Agents
Respiratory Sounds
Medicaid
Smoke
African Americans
Mass Spectrometry
Biomarkers
Logistic Models

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Howrylak, J. A., Spanier, A. J., Huang, B., Peake, R. W. A., Kellogg, M. D., Sauers, H., & Kahn, R. S. (2014). Cotinine in children admitted for asthma and readmission. Pediatrics, 133(2). https://doi.org/10.1542/peds.2013-2422
Howrylak, Judie Ann ; Spanier, Adam J. ; Huang, Bin ; Peake, Roy W.A. ; Kellogg, Mark D. ; Sauers, Hadley ; Kahn, Robert S. / Cotinine in children admitted for asthma and readmission. In: Pediatrics. 2014 ; Vol. 133, No. 2.
@article{5ea3d3afd0ac48259973141cf2819ca7,
title = "Cotinine in children admitted for asthma and readmission",
abstract = "OBJECTIVE: To explore the relationship between tobacco smoke exposure (reported versus biomarker) and rates of readmission for children hospitalized for asthma. METHODS: We enrolled a prospective cohort of 774 children aged 1 to 16 years admitted for asthma or bronchodilator-responsive wheezing. The primary outcome was at least 1 asthma- or wheeze-related readmission within 1 year. Caregivers reported any tobacco exposure at home, in a secondary residence, or in the car. We measured serum and saliva cotinine levels with mass spectrometry. We used logistic regression to evaluate associations between tobacco exposure and readmissions. RESULTS: A total of 619 children had complete tobacco exposure data; 57{\%} were African American and 76{\%} had Medicaid. Seventeen percent of children were readmitted within 1 year. Tobacco exposure rates were 35.1{\%}, 56.1{\%}, and 79.6{\%} by report, serum, and saliva measures, respectively. Caregiver report of any tobacco exposure was not associated with readmission (adjusted odds ratio: 1.18; 95{\%} confidence interval: 0.79-1.89), but having detectable serum or salivary cotinine was associated with increased odds of readmission (adjusted odds ratio [95{\%} confidence interval]: 1.59 [1.02-2.48] and 2.35 [1.22-4.55], respectively). Among children whose caregivers reported no tobacco exposure, 39.1{\%} had detectable serum cotinine and 69.9{\%} had detectable salivary cotinine. Of the children with reported exposure, 87.6{\%} had detectable serum cotinine and 97.7{\%} had detectable salivary cotinine. CONCLUSIONS: Detectable serum and salivary cotinine levels were common among children admitted for asthma and were associated with readmission, whereas caregiver report of tobacco exposure was not.",
author = "Howrylak, {Judie Ann} and Spanier, {Adam J.} and Bin Huang and Peake, {Roy W.A.} and Kellogg, {Mark D.} and Hadley Sauers and Kahn, {Robert S.}",
year = "2014",
month = "2",
day = "1",
doi = "10.1542/peds.2013-2422",
language = "English (US)",
volume = "133",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "2",

}

Howrylak, JA, Spanier, AJ, Huang, B, Peake, RWA, Kellogg, MD, Sauers, H & Kahn, RS 2014, 'Cotinine in children admitted for asthma and readmission', Pediatrics, vol. 133, no. 2. https://doi.org/10.1542/peds.2013-2422

Cotinine in children admitted for asthma and readmission. / Howrylak, Judie Ann; Spanier, Adam J.; Huang, Bin; Peake, Roy W.A.; Kellogg, Mark D.; Sauers, Hadley; Kahn, Robert S.

In: Pediatrics, Vol. 133, No. 2, 01.02.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cotinine in children admitted for asthma and readmission

AU - Howrylak, Judie Ann

AU - Spanier, Adam J.

AU - Huang, Bin

AU - Peake, Roy W.A.

AU - Kellogg, Mark D.

AU - Sauers, Hadley

AU - Kahn, Robert S.

PY - 2014/2/1

Y1 - 2014/2/1

N2 - OBJECTIVE: To explore the relationship between tobacco smoke exposure (reported versus biomarker) and rates of readmission for children hospitalized for asthma. METHODS: We enrolled a prospective cohort of 774 children aged 1 to 16 years admitted for asthma or bronchodilator-responsive wheezing. The primary outcome was at least 1 asthma- or wheeze-related readmission within 1 year. Caregivers reported any tobacco exposure at home, in a secondary residence, or in the car. We measured serum and saliva cotinine levels with mass spectrometry. We used logistic regression to evaluate associations between tobacco exposure and readmissions. RESULTS: A total of 619 children had complete tobacco exposure data; 57% were African American and 76% had Medicaid. Seventeen percent of children were readmitted within 1 year. Tobacco exposure rates were 35.1%, 56.1%, and 79.6% by report, serum, and saliva measures, respectively. Caregiver report of any tobacco exposure was not associated with readmission (adjusted odds ratio: 1.18; 95% confidence interval: 0.79-1.89), but having detectable serum or salivary cotinine was associated with increased odds of readmission (adjusted odds ratio [95% confidence interval]: 1.59 [1.02-2.48] and 2.35 [1.22-4.55], respectively). Among children whose caregivers reported no tobacco exposure, 39.1% had detectable serum cotinine and 69.9% had detectable salivary cotinine. Of the children with reported exposure, 87.6% had detectable serum cotinine and 97.7% had detectable salivary cotinine. CONCLUSIONS: Detectable serum and salivary cotinine levels were common among children admitted for asthma and were associated with readmission, whereas caregiver report of tobacco exposure was not.

AB - OBJECTIVE: To explore the relationship between tobacco smoke exposure (reported versus biomarker) and rates of readmission for children hospitalized for asthma. METHODS: We enrolled a prospective cohort of 774 children aged 1 to 16 years admitted for asthma or bronchodilator-responsive wheezing. The primary outcome was at least 1 asthma- or wheeze-related readmission within 1 year. Caregivers reported any tobacco exposure at home, in a secondary residence, or in the car. We measured serum and saliva cotinine levels with mass spectrometry. We used logistic regression to evaluate associations between tobacco exposure and readmissions. RESULTS: A total of 619 children had complete tobacco exposure data; 57% were African American and 76% had Medicaid. Seventeen percent of children were readmitted within 1 year. Tobacco exposure rates were 35.1%, 56.1%, and 79.6% by report, serum, and saliva measures, respectively. Caregiver report of any tobacco exposure was not associated with readmission (adjusted odds ratio: 1.18; 95% confidence interval: 0.79-1.89), but having detectable serum or salivary cotinine was associated with increased odds of readmission (adjusted odds ratio [95% confidence interval]: 1.59 [1.02-2.48] and 2.35 [1.22-4.55], respectively). Among children whose caregivers reported no tobacco exposure, 39.1% had detectable serum cotinine and 69.9% had detectable salivary cotinine. Of the children with reported exposure, 87.6% had detectable serum cotinine and 97.7% had detectable salivary cotinine. CONCLUSIONS: Detectable serum and salivary cotinine levels were common among children admitted for asthma and were associated with readmission, whereas caregiver report of tobacco exposure was not.

UR - http://www.scopus.com/inward/record.url?scp=84893259679&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893259679&partnerID=8YFLogxK

U2 - 10.1542/peds.2013-2422

DO - 10.1542/peds.2013-2422

M3 - Article

VL - 133

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 2

ER -

Howrylak JA, Spanier AJ, Huang B, Peake RWA, Kellogg MD, Sauers H et al. Cotinine in children admitted for asthma and readmission. Pediatrics. 2014 Feb 1;133(2). https://doi.org/10.1542/peds.2013-2422