Risks for comorbidity in children with atopic disorders: an observational study in Dutch general practices.
OBJECTIVE
This study aimed to investigate both atopic and non-atopic comorbid symptoms and diseases in children with physician-diagnosed atopic disorders (atopic eczema, asthma and allergic rhinitis).


METHODS
All children aged 0-18 years listed in a nationwide primary care database (the Netherlands Institute for Health Services Research-Primary Care Database) with routinely collected healthcare data in 2014 were selected. Children with atopic disorders were matched on age and gender with non-atopic controls within the same general practice. A total of 404 International Classification of Primary Care codes were examined. Logistic regression analyses were performed to examine the associations between the presence of atopic disorders and (non-)atopic symptoms and diseases by calculating ORs.


RESULTS
Having one of the atopic disorders significantly increased the risk of having other atopic-related symptoms, even if the child was not registered as having the related atopic disorder. Regarding non-atopic comorbidity, children with atopic eczema (n=15 530) were at significantly increased risk for (infectious) skin diseases (OR: 1.2-3.4). Airway symptoms or (infectious) diseases (OR: 2.1-10.3) were observed significantly more frequently in children with asthma (n=7887). Children with allergic rhinitis (n=6835) had a significantly distinctive risk of ear-nose-throat-related symptoms and diseases (OR: 1.5-3.9). Neither age nor gender explained these increased risks.


CONCLUSION
General practitioners are not always fully aware of relevant atopic and non-atopic comorbidity. In children known to have at least one atopic disorder, specific attention is required to avoid possible insufficient treatment and unnecessary loss of quality of life.
['Pols|David H J|DHJ|', 'Bohnen|Arthur M|AM|', 'Nielen|Mark M J|MMJ|', 'Korevaar|Joke C|JC|', 'Bindels|Patrick J E|PJE|']
D000293:Adolescent D001249:Asthma D002648:Child D002675:Child, Preschool D015897:Comorbidity D003876:Dermatitis, Atopic D005260:Female D058006:General Practice D006801:Humans D007223:Infant D007231:Infant, Newborn D016015:Logistic Models D008297:Male D009426:Netherlands D015995:Prevalence D011788:Quality of Life D065631:Rhinitis, Allergic
Primary Care Epidemiology Paediatrics