Emergency department visit count: a practical tool to predict asthma hospitalization in children

Area of Science:

• Pediatric Emergency Medicine
• Respiratory Health
• Health Services Research

Background:

• Emergency department (ED) visits for pediatric asthma are common, but resource limitations hinder effective preventative strategies.
• Identifying children at high risk for asthma hospitalization is crucial for targeted interventions.
• Current methods for risk stratification in pediatric asthma are insufficient.

Purpose of the Study:

• To determine if the frequency of emergency department (ED) visits predicts future asthma hospitalizations in children.
• To establish a reliable metric for identifying high-risk pediatric asthma patients.

Main Methods:

• Retrospective analysis of health administrative data for children (2-16.99 years) with asthma ED visits (2012-2015).
• Survival analysis, including Kaplan-Meier and multivariable Cox regression with time-varying covariates.
• Assessed the predictive value of previous year's ED visit count on subsequent year's hospitalization risk, adjusting for age, sex, and severity.

Main Results:

• Identified 2669 children with 3300 asthma-related ED visits.
• ED visit count independently predicted future asthma hospitalizations (p < 0.001) with a dose-dependent relationship.
• Children with one prior ED visit had 2.9 times the hazard of hospitalization; those with two or more had 4.4 times the hazard, compared to those with no prior visits.

Conclusions:

• The number of emergency department (ED) visits serves as a reliable predictor of future asthma hospitalization risk in children.
• ED visit count can be a practical, objective tool for identifying high-risk pediatric asthma patients.
• Findings support the use of ED visit frequency to target preventative interventions for children with asthma.