Anna Chen Arroyo, MD, MPH

All Publications

• Trends in U.S. hospitalizations for anaphylaxis among infants and toddlers: 2006-2015. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Robinson, L. B., Arroyo, A. C., Faridi, M. K., Rudders, S. A., Camargo, C. A. 2020

  Abstract

  BACKGROUND: Anaphylaxis is a potentially fatal acute allergic reaction. Its overall prevalence appears to be rising, but little is known about U.S. hospitalization trends among infants and toddlers.OBJECTIVE: To identify the trends and predictors of hospitalization for anaphylaxis among infants and toddlers.METHODS: We used the nationally representative National Inpatient Sample (NIS), from 2006-2015, to perform an analysis of trends in U.S. hospitalizations for anaphylaxis among infants and toddlers (age <3 years) and other children (age 3-18 years). For internal consistency, we identified patients with anaphylaxis by ICD-9-CM diagnosis code and excluded those with ICD-10-CM (late 2015). We calculated trends in anaphylaxis hospitalizations over time by age group, then used multivariable logistic regression to describe anaphylaxis hospitalizations among infants and toddlers.RESULTS: Among infants and toddlers, there was no significant change in anaphylaxis hospitalizations during the 10-year study period (P trend =0.14). Anaphylaxis hospitalization among infants and toddlers was more likely in males, with private insurance, in the highest income quartile, with chronic pulmonary disease, who presented on a weekend day, to an urban teaching hospital, located in the Northeast. In contrast, anaphylaxis hospitalizations among older children (age 3 to <18 years) rose significantly during the study (P trend <0.001).CONCLUSION: Anaphylaxis hospitalizations among infants and toddlers in the US were stable from 2006-2015, while hospitalizations among older children were rising. Future research should focus on the trends in disease prevalence and healthcare utilization in the understudied population of infants and toddlers.

  View details for DOI 10.1016/j.anai.2020.09.003

  View details for PubMedID 32911059

• Prenatal exposure to acid-suppressant medications and the risk of recurrent wheeze at 3 years of age in children with a history of severe bronchiolitis. The journal of allergy and clinical immunology. In practice Robinson, L. B., Chen Arroyo, A. J., Dantas, M. A., Espinola, J. A., Sullivan, A. F., Camargo, C. A. 2019

  View details for DOI 10.1016/j.jaip.2019.02.039

  View details for PubMedID 30878709

• Where do children die from asthma? National data from 2003 to 2015 JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE Arroyo, A., Chee, C., Camargo, C. A., Wang, N. 2018; 6 (3): 1034?36

  View details for PubMedID 28970087

  View details for PubMedCentralID PMC5876061

• Occupational exposures and asthma prevalence among US farmworkers: National Agricultural Workers Survey, 2003-2014. The journal of allergy and clinical immunology. In practice Arroyo, A. J., Robinson, L. B., Downing, N. L., Camargo, C. A. 2018

  View details for PubMedID 29626636

• Staphylococcal infections in children, California, USA, 1985-2009. Emerging infectious diseases Gutierrez, K., Halpern, M. S., Sarnquist, C., Soni, S., Arroyo, A. C., Maldonado, Y. 2013; 19 (1): 10-20

  Abstract

  We conducted a retrospective, observational, population-based study to investigate the effect of staphylococcal infections on the hospitalization of children in California during 1985-2009. Hospitalized children with staphylococcal infections were identified through the California Office of Statewide Health Planning and Development discharge database. Infections were categorized as community onset, community onset health care-associated, or hospital onset. Infection incidence was calculated relative to all children and to those hospitalized in acute-care facilities. A total of 140,265 records were analyzed. Overall incidence increased from 49/100,000 population in 1985 to a peak of 83/100,000 in 2006 and dropped to 73/100,000 in 2009. Staphylococcal infections were associated with longer hospital stays and higher risk for death relative to all-cause hospitalizations of children. The number of methicillin-resistant Staphylococcus aureus infections increased, and the number of methicillin-susceptible S. aureus infections remained unchanged. Children <3 years of age, Blacks, and those without private insurance were at higher risk for hospitalization.

  View details for DOI 10.3201/eid1901.111740

  View details for PubMedID 23260060

• The association between insurance status and emergency department disposition of injured California children. Academic emergency medicine Arroyo, A. C., Ewen Wang, N., Saynina, O., Bhattacharya, J., Wise, P. H. 2012; 19 (5): 541-551

  Abstract

  This study examined the relationship between insurance status and emergency department (ED) disposition of injured California children.Multivariate regression models were built using data obtained from the 2005 through 2009 California Office of Statewide Health Planning and Development (OSHPD) data sets for all ED visits by injured children younger than 19 years of age.Of 3,519,530 injury-related ED visits, 52% were insured by private, and 36% were insured by public insurance, while 11% of visits were not insured. After adjustment for injury characteristics and demographic variables, publicly insured children had a higher likelihood of admission for mild, moderate, and severe injuries compared to privately insured children (mild injury adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI] = 1.34 to 1.39; moderate and severe injury AOR = 1.34, 95% CI = 1.28 to 1.41). However, uninsured children were less likely to be admitted for mild, moderate, and severe injuries compared to privately insured children (mild injury AOR = 0.63, 95% CI = 0.61 to 0.66; moderate and severe injury AOR = 0.50, 95% CI = 0.46 to 0.55). While publicly insured children with moderate and severe injuries were as likely as privately insured children to experience an ED death (AOR = 0.91, 95% CI = 0.70 to 1.18), uninsured children with moderate and severe injuries were more likely to die in the ED compared to privately insured children (AOR = 3.11, 95% CI = 2.38 to 4.06).Privately insured, publicly insured, and uninsured injured children have disparate patterns of ED disposition. Policy and clinical efforts are needed to ensure that all injured children receive equitable emergency care.

  View details for DOI 10.1111/j.1553-2712.2012.01356.x

  View details for PubMedID 22594358

  View details for PubMedCentralID PMC3443629