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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Long-term asthma-related readmissions: comparison between children admitted and not admitted to the intensive care
Imane Jroundi1, Sze Man Tse2,3
1Department of Pediatrics, Unit of Training and Research in Public Health, School of Medicine and Pharmacy of Rabat, University of Mohamed V of Rabat, Rabat, Morocco.
Insights
Children admitted to the intensive care unit (ICU) for asthma face a higher risk of readmission. Factors like young age and longer initial hospital stays increase this risk for pediatric asthma patients.
Area of Science:
- Pediatric Pulmonology
- Healthcare Outcomes Research
Background:
- Asthma is a common chronic respiratory disease in children.
- Hospitalization for asthma can be associated with significant morbidity and healthcare utilization.
Purpose of the Study:
- To compare asthma-related readmission rates between pediatric intensive care unit (ICU) and non-ICU admissions.
- To identify risk factors for readmission in children hospitalized in the ICU for asthma.
Main Methods:
- Retrospective cohort study using the State Inpatient Database (2005-2014).
- Included children aged 2-17 years hospitalized for asthma in four U.S. states.
- Compared time to readmission and emergency department (ED) visits using log-rank tests and Cox regression for risk factor analysis.
Main Results:
- Over 66,000 children hospitalized for asthma; 14% were admitted to the ICU.
- ICU admissions were associated with shorter time to asthma-related readmission (p < 0.001).
- Risk factors for ICU readmission included preschool age, female sex, Black race, lower income, and longer initial hospital stay.
Conclusions:
- Pediatric ICU admission for asthma increases the risk of subsequent asthma-related readmission.
- Specific demographic and clinical factors further elevate readmission risk in this vulnerable population.
Objectives:
To compare the time to asthma-related readmission between children admitted to the intensive care unit (ICU) for asthma and those with a non-ICU hospitalization in the United States and to explore risk factors associated with readmission among children admitted in the ICU.
Methods:
In this retrospective cohort study, we included children aged 2-17 years in the State Inpatient Database (2005-2014) from four U.S. states who were hospitalized for asthma. We compared the time to asthma-related readmissions and emergency department (ED) visit between children admitted and not admitted to the ICU using the log-rank test. Among those admitted to the ICU, we explored factors associated with readmission using Cox regression.
Results:
66 835 children were hospitalized for asthma, with 14.0% admitted to the ICU, and 12 844 were readmitted for asthma while 22 915 had an asthma-related ED visit. The time to asthma-related readmission was shorter in the ICU group compared to the non-ICU group (p < 0.001), but the time to asthma-related ED visit did not differ between the two groups (p = 0.43). Being preschool-aged, female, Black, and having lower household income and a longer length of stay during the initial hospitalization conferred a higher risk of asthma-related readmission among children admitted to the ICU. Preschool age and Medicaid were Florida-specific risk factors while Hispanic ethnicity was New York-specific.
Conclusion:
Compared to children not admitted to the ICU, children admitted to the ICU for asthma were at increased risk of asthma-related readmission, with certain risk factors conferring an even higher risk.
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