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Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system. Pediatr Emerg Care 2008 Aug;24(8):505-10

Date

07/23/2008

Pubmed ID

18645538

DOI

10.1097/PEC.0b013e318180fdcb

Scopus ID

2-s2.0-53049097459   35 Citations

Abstract

OBJECTIVE: To identify clinical variables associated with a greater likelihood of emergency department (ED) revisit for acute asthma within 7 days after an initial ED visit for acute asthma exacerbation.

METHODS: Cross-sectional study of subjects from a prospectively enrolled cohort of children aged 0 to 18 years with physician-diagnosed asthma in the ED Allies Tracking System. Demographics and data on quality of life, health care utilization, environmental factors, chronic asthma severity, and ED management were collected. Emergency department revisits for acute asthma within 7 days of a prior visit resulting in discharge were compared with those without a revisit, using chi2 and t tests and logistic regression.

RESULTS: Four thousand two hundred twenty-eight ED asthma visits were enrolled; 3276 visits resulted in discharge. Persistent asthma was identified in 66% of visits. Emergency department revisits within 7 days of a prior visit occurred following 133 (4.1%) visits. There were no significant differences in environmental factors or ED management between visits with and without an ED revisit. In univariate analysis factors associated with a greater revisit likelihood included age younger than 2 years, black race or Hispanic ethnicity, persistent asthma, public insurance, lower quality of life, and greater health care utilization in the prior 12 months. Variables independently significant (P < 0.05) in logistic regression were chronic asthma severity classified as persistent, age younger than 2 years, and lower asthma quality of life.

CONCLUSIONS: Although our design precludes drawing causal inference, our results suggest that children younger than 2 years or with persistent asthma or lower asthma quality-of-life scores are at greater risk for ED revisits after acute ED asthma care.

Author List

Walsh-Kelly CM, Kelly KJ, Drendel AL, Grabowski L, Kuhn EM

Author

Amy L. Drendel DO Professor in the Pediatrics department at Medical College of Wisconsin




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

Acute Disease
Adolescent
Ambulatory Care Information Systems
Asthma
Child
Child, Preschool
Cohort Studies
Cross-Sectional Studies
Emergency Service, Hospital
Humans
Infant
Infant, Newborn
Medical Records Systems, Computerized
Quality of Life
Recurrence
Wisconsin