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Children with asthma admitted to a pediatric observation unit.
Pediatr Emerg Care. 2005 Oct; 21(10):645-9.PE

Abstract

OBJECTIVE

Observation units (OUs) serve patients who require more evaluation or treatment than possible during an emergency department visit and who are anticipated to stay in the hospital for a short defined period. Asthma is a common admission diagnosis in a pediatric OU. Our main objective was to identify clinical factors associated with failure to discharge a child with asthma from our OU within 24 hours.

METHODS

Retrospective chart review at a tertiary care children's hospital. Participants were children 2 years or older with asthma admitted from the emergency department to the OU during August 1999 to August 2001. The OU-discharged group comprised those successfully discharged from the OU within 24 hours. The unplanned inpatient admission group comprised those subsequently admitted from the OU to a traditional inpatient ward or those readmitted to the hospital within 48 hours of OU discharge.

RESULTS

One hundred sixty-one children aged 2 to 20 years (median 4.0; 63% boys) met inclusion criteria; 40 patients (25%) required unplanned inpatient admission. In a multiple logistic regression model, 3 factors were associated with need for unplanned inpatient admission: female sex (adjusted odds ratio, 2.6; 95% confidence interval, 1.1-6.4; P = 0.03), temperature 38.5 degrees C or higher (adjusted odds ratio, 6.1; 95% confidence interval, 1.6-23.5; P < 0.01), and need for supplemental oxygen at the end of emergency department management (adjusted odds ratio, 5; 95% confidence interval, 1.7-15.1; P < 0.01).

CONCLUSIONS

Many children with asthma can be admitted to a pediatric OU and discharged safely within 24 hours. Prospective studies are needed to confirm our findings and to identify other factors predictive of unplanned inpatient admission.

Authors+Show Affiliations

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT 84158, USA. michael.miescier@hsc.utah.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16215465

Citation

Miescier, Michael J., et al. "Children With Asthma Admitted to a Pediatric Observation Unit." Pediatric Emergency Care, vol. 21, no. 10, 2005, pp. 645-9.
Miescier MJ, Nelson DS, Firth SD, et al. Children with asthma admitted to a pediatric observation unit. Pediatr Emerg Care. 2005;21(10):645-9.
Miescier, M. J., Nelson, D. S., Firth, S. D., & Kadish, H. A. (2005). Children with asthma admitted to a pediatric observation unit. Pediatric Emergency Care, 21(10), 645-9.
Miescier MJ, et al. Children With Asthma Admitted to a Pediatric Observation Unit. Pediatr Emerg Care. 2005;21(10):645-9. PubMed PMID: 16215465.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Children with asthma admitted to a pediatric observation unit. AU - Miescier,Michael J, AU - Nelson,Douglas S, AU - Firth,Sean D, AU - Kadish,Howard A, PY - 2005/10/11/pubmed PY - 2006/6/29/medline PY - 2005/10/11/entrez SP - 645 EP - 9 JF - Pediatric emergency care JO - Pediatr Emerg Care VL - 21 IS - 10 N2 - OBJECTIVE: Observation units (OUs) serve patients who require more evaluation or treatment than possible during an emergency department visit and who are anticipated to stay in the hospital for a short defined period. Asthma is a common admission diagnosis in a pediatric OU. Our main objective was to identify clinical factors associated with failure to discharge a child with asthma from our OU within 24 hours. METHODS: Retrospective chart review at a tertiary care children's hospital. Participants were children 2 years or older with asthma admitted from the emergency department to the OU during August 1999 to August 2001. The OU-discharged group comprised those successfully discharged from the OU within 24 hours. The unplanned inpatient admission group comprised those subsequently admitted from the OU to a traditional inpatient ward or those readmitted to the hospital within 48 hours of OU discharge. RESULTS: One hundred sixty-one children aged 2 to 20 years (median 4.0; 63% boys) met inclusion criteria; 40 patients (25%) required unplanned inpatient admission. In a multiple logistic regression model, 3 factors were associated with need for unplanned inpatient admission: female sex (adjusted odds ratio, 2.6; 95% confidence interval, 1.1-6.4; P = 0.03), temperature 38.5 degrees C or higher (adjusted odds ratio, 6.1; 95% confidence interval, 1.6-23.5; P < 0.01), and need for supplemental oxygen at the end of emergency department management (adjusted odds ratio, 5; 95% confidence interval, 1.7-15.1; P < 0.01). CONCLUSIONS: Many children with asthma can be admitted to a pediatric OU and discharged safely within 24 hours. Prospective studies are needed to confirm our findings and to identify other factors predictive of unplanned inpatient admission. SN - 1535-1815 UR - https://www.unboundmedicine.com/medline/citation/16215465/Children_with_asthma_admitted_to_a_pediatric_observation_unit_ L2 - https://doi.org/10.1097/01.pec.0000181425.87224.f5 DB - PRIME DP - Unbound Medicine ER -