Faculty Collaboration Database

Pediatric asthma severity scores distinguish suitable inpatient level of care for children admitted for status asthmaticus. J Asthma 2021 Feb;58(2):151-159

Date

10/15/2019

Pubmed ID

31608716

DOI

10.1080/02770903.2019.1680998

Scopus ID

2-s2.0-85074521237 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

Objective: To determine if the Pediatric Asthma Severity Score (PASS) can distinguish "late-rescues" (transfer to the pediatric intensive care unit [PICU] within 24-hours of general pediatric floor admission), "PICU readmissions" (readmission within 24-h after transfer to a lower inpatient level of care), and unplanned 30-day hospital readmission in children admitted with status asthmaticus.Methods: We performed a single center, retrospective cohort study in 328 children admitted for asthma exacerbation aged 5-18 years from May 2015 to October 2017. We sought to determine if PASS values preceding admission from the emergency department or transfer to the general pediatric unit will be greater in children with late rescues and PICU readmissions and if a cutoff PASS values exist to discriminate these events prior to intrafacility transfer.Results: Nine (5%) late-rescues and 5 (3%) PICU readmissions accounted for 14/328 (4%) composite outcomes. PASS values were greater in children with these events (8 [IQR:5-8] vs. 5 [IQR:3-6], p < .01). Logistic regression of PASS on composite outcome yielded an odds ratio of 1.4 (1.1-1.8, p < .01) and ROC curve of PASS on a composite outcome yielded an AUC of 0.74 (0.61-0.87) with a threshold of ≥ 9. Nine (3%) children experienced unplanned 30-day hospital readmissions but PASS preceding hospital discharge was neither discriminative nor associated with hospital readmission.Conclusions: PASS values ≥ 9 identify children at increased risk for late-rescue and PICU readmission. Applied with traditionally criteria for selection of inpatient level of care, PASS may assist providers in reducing acute inpatient disposition errors.

Author List

Ryan KS, Son S, Roddy M, Siraj S, McKinley SD, Nakagawa TA, Sochet AA

Author

Kelsey S. Ryan MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Age Factors
Child
Child, Preschool
Comorbidity
Emergency Service, Hospital
Female
Humans
Intensive Care Units, Pediatric
Length of Stay
Male
Patient Readmission
Retrospective Studies
Risk Factors
Severity of Illness Index
Socioeconomic Factors
Status Asthmaticus