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Risk factors for multiple hospital admissions among children and adolescents with asthma
Laura Maria de Lima Belizario Facury Lasmar1, Paulo Augusto Moreira Camargos, Eugênio Marcos Andrade Goulart
1Pediatrics Department, Universidade Federal de Minas Gerais, School of Medicine, Belo Horizonte, Brazil.
Insights
Infants hospitalized for asthma face a high risk of readmission, particularly those under two years old. Early intervention and close monitoring post-discharge are crucial for managing childhood asthma readmissions.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Childhood asthma is a significant cause of hospital admissions.
- Understanding risk factors for recurrent hospitalizations is vital for effective management.
- Previous admissions may indicate underlying disease severity or treatment challenges.
Purpose of the Study:
- To investigate the influence of initial hospital admission for asthma in young children on subsequent readmission risk.
- To identify specific risk factors associated with multiple hospitalizations for pediatric asthma.
Main Methods:
- Retrospective study evaluating 202 pediatric patients (<15 years) with prior hospitalizations for asthma.
- Analysis of outpatient and inpatient records from a pediatric pulmonology clinic.
- Multivariate analysis to determine risk factors for recurrent hospital admissions.
Main Results:
- Nearly all patients experienced a second hospitalization within 18 months of the first.
- Younger age at first admission (<12 months and 13-24 months) significantly increased readmission risk.
- Increased severity of asthma symptoms was a major risk factor for multiple hospital admissions (OR: 3.86).
Conclusions:
- Children with asthma require close monitoring after their first hospitalization due to elevated readmission risk.
- The risk is particularly high in the months following discharge, especially for children under two years old.
- Healthcare facilities should optimize management strategies and consider proactive prophylactic medication for high-risk pediatric asthma patients.
Objective:
To determine the influence that hospital admission of suckling infants with asthma has on their risk for future admissions for the same cause.
Methods:
A retrospective study was conducted, in which the charts of 202 patients, all less than fifteen years of age, were evaluated. All of the patients had been treated as outpatients in a pediatric pulmonology clinic and had been admitted to the hospital on one or more occasions. A multivariate analysis was conducted in order to evaluate the risk factors associated with multiple hospitalizations.
Results:
Virtually all of the patients evaluated were hospitalized a second time within 18 months of the first hospitalization. Among the patients first hospitalized at = 12 months of age, the second admission occurred sooner than did that recorded for those first hospitalized at > 12 months of age (p = 0.001). The risk factors found to be associated with multiple hospital admissions were as follows: age at first admission = 12 months (odds ratio: 2.55; 95% confidence interval: 1.18-5.48); age at first admission between 13 and 24 months (odds ratio: 3.54; 95% confidence interval: 1.31-9.63); and severity of asthma symptoms (odds ratio: 3.86; 95% confidence interval: 2.02-7.40).
Conclusion:
After the first hospitalization, children with asthma should be closely monitored, since the risk of subsequent admissions is elevated in the first months following discharge, especially among those of less than two years of age. Health care facilities should be organized to confront this problem appropriately and should dispense prophylactic medication more freely.
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