Predicting future emergency department visits and hospitalizations for asthma using the Pediatric Asthma Control and...

Area of Science:

• Pediatric emergency medicine
• Respiratory health outcomes
• Clinical informatics

Background:

• Emergency departments (EDs) are crucial for managing pediatric asthma exacerbations.
• Effective screening tools are needed in EDs to identify children at high risk for future asthma-related morbidity.
• The Pediatric Asthma Control and Communication Instrument - Emergency Department version (PACCI-ED) was developed for this purpose.

Purpose of the Study:

• To evaluate the predictive validity of the PACCI-ED for future asthma-related emergency department (ED) visits and hospitalizations in children.
• To determine which components of the PACCI-ED are most effective in predicting these outcomes.

Main Methods:

• A retrospective cohort study involving 108 children (1-17 years) treated for asthma in an ED.
• Children completed the PACCI-ED, which assesses prior asthma history, perceived burden, and control.
• Subsequent ED visits and hospitalizations within one year were tracked as primary outcomes.
• Poisson regression analysis was used to model the predictive value of PACCI-ED questions, controlling for age and socioeconomic status.

Main Results:

• Parent-reported prior ED visits predicted future ED visits (aIRR 3.1).
• Parent-reported prior hospitalizations predicted future ED visits (aIRR 3.3) and future hospitalizations (aIRR 6.4).
• No other PACCI-ED questions or domains demonstrated predictive validity for future asthma-related healthcare utilization.

Conclusions:

• The risk domain of the PACCI-ED, specifically questions about previous ED visits and hospitalizations, effectively predicts future asthma-related ED visits and hospitalizations.
• These specific questions are valuable for screening children with asthma in the ED setting to identify those at higher risk for future healthcare needs.