Corticosteroid therapy and need for hospital care in wheezing preschool children

Objectives: To study the frequency of corticosteroid therapy and the use of inpatient care for preschool children with wheezing in two regions in Finl and. Methods: The Finnish Social Insurance Institution database on refundable as thma medication indicated that 1.18% of children in Tampere and 2.37% in Tu rku used inhaled corticosteroids regularly. To clarify the difference, hosp ital records of 800 randomly chosen 0.5-6.9-year-old children who had been treated for wheezing in Tampere or Turku University Hospital during 1995-19 96 were retrospectively analysed. Results: The incidences of wheezing-related emergency room (ER) index visit s were 11.0 visits/year/1000 children both in Tampere and Turku. Oral corti costeroids were given to 2.5% versus 24.2% of children in ER and 10.6% vers us 89.7% in hospital ward in Tampere and Turku, respectively. Hospitalisati on rates were 44.8% in Tampere and 36.8% in Turku (95% confidence interval for the difference 1.2-14.8%). In both regions, children with prior inhaled corticosteroid therapy needed less inpatient care. Mean duration of hospit alisation was 3.4 days in Tampere and only 1.4 days in Turku. Recurrent vis its in 6 months were more common in Tampere. Conclusions: There were marked regional differences in the management of pr eschool children with wheezing. On a population level, frequent use of cort icosteroid therapy was associated with reduced hospital admissions.