(872) Correlation Between Total IgE Level and Asthma Symptom Severity in Hospitalized Children

Introduction: Status asthmaticus is a common reason for hospitalization and pediatric intensive care unit (PICU) admission among children. While previous studies have demonstrated a correlation between elevated IgE levels and asthma severity in outpatient settings, studies analyzing IgE levels in an inpatient cohort are limited. This analysis could help identify children at risk of life-threatening asthma exacerbations for early referral for targeted therapy.
In this study our objective was to demonstrate a relationship between baseline IgE levels and symptom severity on admission, degree of respiratory support required during admission, and PICU and hospital length of stay in an inpatient pediatric cohort.

Methods: This was a single center retrospective chart review. Children admitted to the Children’s Hospital at Montefiore (CHAM) for status asthmaticus as their primary diagnosis from January 1, 2015-July 1, 2022 and with IgE levels documented within six months of admissions were included in the study. Primary goal was to determine the relationship between baseline IgE levels (IU/ml) and whether the patient was admitted to the PICU or the general pediatric floor. Secondary variables included maximum respiratory support and PICU and hospital length of stay in days.

Results: We identified a statistically significant difference (p=0.001) in baseline IgE levels between the PICU group (median 556.7 IU/ml) and the floor group (321.0 IU/ml). IgE levels were also significantly higher in patients requiring positive pressure ventilation (median = 538.0 IU/ml) compared to those who did not require positive pressure ventilation (median= 367IU/ml, p = 0.033). There was a positive correlation between IgE level and PICU length of stay (p = 0.003). However, IgE levels and HLOS did not have significant correlation (p = 0.211).

Conclusions: Elevated baseline IgE level is correlated with higher asthma symptom severity when hospitalized and with longer PICU length of stay. This information is consistent with prior studies in which patients with higher IgE levels were categorized into severe asthma phenotype groups. Our study adds to the growing body of evidence that those with high baseline IgE levels are likely to have severe asthma and may require PICU admission.