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Short-term outcomes after acute treatment of pediatric asthma

M W Stevens1, M H Gorelick

  • 1Department of Pediatrics, Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. msteve@chmc.org

Pediatrics
|June 5, 2001
PubMed

Insights

Pediatric asthma patients treated in the emergency department (ED) experience significant short-term illness, including persistent symptoms and functional disability. Standard ED success markers like avoiding hospital admission do not fully capture the recovery of children with acute asthma.

Area of Science:

  • Pediatric Emergency Medicine
  • Respiratory Medicine
  • Public Health

Background:

  • Short-term outcomes for pediatric asthma patients post-emergency department (ED) treatment are under-documented.
  • Previous studies focused narrowly on ED length of stay, hospital admission, and relapse rates.

Purpose of the Study:

  • To comprehensively assess symptom persistence, medication use, functional disability, and follow-up in children after acute asthma treatment and ED discharge.
  • To evaluate relapse rates and patient-oriented outcomes within two weeks of ED care.

Main Methods:

  • Prospective cohort study of pediatric asthma patients treated in an inner-city hospital ED.
  • Telephone interviews conducted at 1 and 2 weeks post-discharge for 367 patients.
  • Data collected on symptom duration, activity levels, school/work absenteeism, medication use, and follow-up care.

Main Results:

  • Significant morbidity observed: 23% had persistent cough, 12% wheezing at 2 weeks.
  • 20% experienced decreased activity, and substantial school/daycare (45%) and work absenteeism (54%) occurred.
  • 32% used increased medication, relapse rate was 13%, and routine follow-up was poor (48% had no visit planned).

Conclusions:

  • Inner-city pediatric asthma patients discharged from the ED often have poor short-term outcomes.
  • Traditional markers like hospital admission and relapse do not fully represent the impact of acute asthma care.
  • Patient-centered outcomes, including symptom persistence and functional disability, offer a more accurate evaluation of ED treatment effectiveness.
Abstract

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