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Risk factors for repeat adverse asthma events in children after visiting an emergency department

Teresa To1, Chengning Wang, Sharon Dell

  • 1Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. teresa.to@sickkids.ca

Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association
|October 17, 2008
PubMed

Insights

Children with asthma visiting the emergency department (ED) showed improved outcomes at six months. Drug insurance and regular bed linen washing were linked to fewer asthma episodes and ED visits.

Area of Science:

  • Pediatric Pulmonology
  • Public Health
  • Health Services Research

Background:

  • Asthma is a common chronic respiratory disease in children.
  • Emergency department (ED) visits for pediatric asthma represent a significant healthcare burden.
  • Identifying factors influencing long-term outcomes post-ED care is crucial for effective management.

Purpose of the Study:

  • To identify risk factors for adverse long-term asthma outcomes in children after ED visits.
  • To assess the impact of drug insurance coverage on pediatric asthma management.
  • To evaluate trends in acute asthma episodes and ED utilization post-discharge.

Main Methods:

  • Prospective observational study at a pediatric tertiary hospital ED in Ontario, Canada.
  • Outcomes (acute asthma episodes, ED visits) tracked at baseline, 1, and 6 months post-discharge.
  • Generalized estimating equations and logistic regression analyzed outcome trends and risk factors.

Main Results:

  • 81.8% of 269 children completed follow-up; ED use decreased significantly by 6 months (39.4% to 26.8%).
  • Children with drug insurance had fewer acute asthma episodes (AOR=0.36) and repeat ED visits (AOR=0.45).
  • Previous asthma events and infections were risk factors; weekly hot water linen washing was protective.

Conclusions:

  • Pediatric asthma patients showed improved long-term outcomes after ED care.
  • Identified risk factors, including lack of insurance, can target interventions for vulnerable populations.
  • Strategies should focus on maximizing insurance coverage and enhancing asthma self-management education.
Abstract

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