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Predictors of asthma-related pediatric emergency department visits and hospitalizations
Concettina Tolomeo1, Carol Savrin, Marjorie Heinzer
1Pediatric Respiratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA. Tina.Tolomeo@yale.edu
Insights
A previous emergency department visit and older age predict future pediatric asthma hospitalizations. Early identification and self-management support are crucial for children with asthma.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Health
- Clinical Epidemiology
Background:
- Asthma is a major cause of pediatric emergency department (ED) visits and hospitalizations in the US.
- Effective prediction of these events is vital for timely intervention.
Purpose of the Study:
- To identify key variables predicting subsequent pediatric asthma-related ED visits and hospitalizations.
- To inform strategies for preventing severe asthma exacerbations in children.
Main Methods:
- Retrospective descriptive study of 298 children hospitalized for asthma in 2006.
- Analysis of 12-month pre- and post-admission data.
- Chi-square and logistic regression analyses to identify predictors.
Main Results:
- A prior ED visit significantly predicted both future ED visits and hospitalizations.
- Increasing age was an independent risk factor for subsequent hospitalizations.
- Males comprised 60% of the study sample.
Conclusions:
- Early identification of children with asthma is essential for proactive management.
- Empowering school-aged children and preadolescents in asthma self-management is recommended.
Objective:
Asthma is a leading cause of emergency department visits and hospitalizations for children in the United States. As part of a larger study, the purpose of this analysis was to determine which variables were most effective at predicting subsequent pediatric asthma-related emergency department visits and hospitalizations.
Methods:
A retrospective, descriptive study was conducted. Subjects consisted of a convenience sample of 298 children admitted to a New England Children's Hospital in 2006 with a primary diagnosis of asthma. Data from two hospital databases were collected for 12 months before and 12 months after the 2006 admission. Basic descriptive statistics were followed by chi-square tests to determine which variables were associated with emergency department visits and hospitalizations. Logistic regression analysis was used to determine which variables were significant predictors of asthma-related emergency department visits and hospitalizations.
Results:
Sixty-percent of all subjects were male. Ninety subjects experienced a total of 145 emergency department visits and 54 experienced a total of 70 hospitalizations. A previous emergency department visit was a significant predictor of both subsequent emergency department visits and subsequent hospitalizations. Age was also an independent risk factor for subsequent hospitalizations. In this sample, the risk of a hospitalization increased with each year increase in age.
Conclusion:
These findings support the importance of early identification of children with asthma so that appropriate asthma management can be instituted before an emergency department visit occurs. Furthermore, results suggest involving school-age and preadolescent children in the care of their asthma so that they can be equipped and encouraged to self-manage their own asthma.
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