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Time to Asthma-Related Readmission in Children Admitted to the ICU for Asthma
Sze Man Tse1, Christian Samson2
1Division of Respiratory Medicine, Department of Pediatrics, Sainte-Justine University Hospital Center and University of Montreal, Montreal, QC, Canada.
Insights
Children previously hospitalized in the intensive care unit (ICU) for asthma face shorter times to readmission. Preschool-aged children and those with longer hospital stays are at higher risk for future asthma-related illness.
Area of Science:
- Pediatric Pulmonology
- Health Services Research
- Epidemiology
Background:
- Asthma is a common chronic respiratory disease in children, frequently leading to hospitalizations.
- Previous intensive care unit (ICU) admission for asthma may indicate higher disease severity and increased risk for future exacerbations.
- Understanding readmission patterns is crucial for optimizing post-discharge care and resource allocation.
Purpose of the Study:
- To compare the time to asthma-related readmission between pediatric patients with prior ICU hospitalization versus non-ICU hospitalization.
- To identify predictors of readmission time in children who were admitted to the ICU for asthma.
Main Methods:
- Retrospective cohort study utilizing a pan-Canadian administrative inpatient database.
- Inclusion of pediatric patients aged 2-17 years hospitalized for asthma between April 1, 2008, and March 31, 2014.
- Analysis of readmission times and associated risk factors, including age and length of stay.
Main Results:
- A total of 26,168 children experienced 33,304 asthma hospitalizations during the study period.
- The median time to readmission was significantly shorter for children with a previous ICU stay (27 months) compared to those without (35 months).
- Preschool-aged children (HR 1.48) and longer hospital stays (HR 1.63) were associated with a shorter time to readmission.
Conclusions:
- Children with prior ICU admission for asthma require more intensive post-discharge follow-up due to a higher risk of readmission.
- Preschool age and extended length of hospital stay are key indicators of increased risk for subsequent asthma-related morbidity.
- Targeted interventions for high-risk pediatric asthma patients can potentially reduce readmission rates and improve long-term outcomes.
Objectives:
To compare the time to asthma-related readmissions between children with a previous ICU hospitalization for asthma and those with a non-ICU hospitalization and to explore predictors of time to readmission in children admitted to the ICU.
Design:
Retrospective cohort study using a pan-Canadian administrative inpatient database from April 1, 2008, to March 31, 2014.
Setting:
All adult and pediatric Canadian hospitals.
Subjects:
Children 2-17 years old with a hospitalization for asthma.
Interventions:
None.
Measurements And Main Results:
A total of 26,168 children were hospitalized 33,304 times during the study period. The time to readmission was shorter in the ICU group compared with the non-ICU group (median time to readmission 27 mo in ICU vs 35 mo in non-ICU group). Preschool-aged children (hazard ratio, 1.48; 95% CI, 1.02-2.14) and increased length of stay (hazard ratio, 1.63; 95% CI, 1.17-2.27) were associated with a shorter time to readmission.
Conclusions:
Children previously admitted to the ICU for asthma had a shorter time to asthma-related readmission, compared with children who did not require intensive care, underlining the importance of targeted long-term postdischarge follow-up of these children. Children of preschool age and who have a lengthier hospital stay are particularly at risk for future morbidity.
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